Natremia/Kalemia

Question 1

Hyperglycemia effect on plasma Na and plasma osmolarity?

Answer 1

Pseudohyponatremia, increased plasma osmolarity

Question 2

Hyperlipidemia effect on plasma Na and plasma osmolarity

Answer 2

Pseudohyponatremia, normal plasma osmolarity

Question 3

Fluid Loss effect on plasma Na, Urine Na, BV

Answer 3

All Decreased

Question 4

Edema (CHF, cirrhosis) effect on plasma Na, Urine Na, BV?

Answer 4

Hyponatremia, Decreased Urine Na, Increased BV

Question 5

Salt-Wasting effect on plasma Na, Urine Na, BV

Answer 5

Hyponatremia, increased Urine Na, Decreased BV

Question 6

Other Causes of salt wasting

Answer 6

Diuretics, Metabolic acidosis, decreased aldosterone, hypothyroidism (MAD LAH)

Question 7

Overproduction of ADH effect on Plasma Na, Urine Na, BV

Answer 7

Hyponatremia, increased Urine Na, Increased BV

Question 8

Stimulation of ADH release?

Answer 8

Pain, Esophageal damage, Low BV, Tuberculosis

Question 9

Causes of Urine Na <100 mMol

Answer 9

No ADH Secretion (Primary Polydipsia, Beer, Tea and Toast)

Question 10

Hypernatremia with Urine Na >800

Answer 10

#1: Primary Hypodipsia 
#2 GI loss 
Rarely Na Overload

Question 11

Hypernatremia with Urine Na <300

Answer 11

DI

Question 12

Symptoms specific for HyPERnatremia and not hyPOnatremia?

Answer 12

Irritability, Cerebral Vascular Rupture

Question 13

Metabolic Acidosis does what to plasma K?

Answer 13

Increases Plasma K, decreases cellular K

Question 14

Insulin does what to K?

Answer 14

Decreases plasma K, increases Cellular K

Question 15

Aldosterone does what to K?

Answer 15

Decreases plasma K, increases Urine K

Question 16

Digoxin does what to K?

Answer 16

CAUSES hyperkalemia, AGGRIVATED BY hypokalemia

Question 17

Hypokalemia with High Urine K, alkalosis and hypertension?

Answer 17

Overproduction of Aldo or Renin

Question 18

Hypokalemia with High Urine K, alkalosis and normal BP?

Answer 18

Loop Diuretic

Question 19

Hypokalemia with high Urine K and acidosis?

Answer 19

Metabolic Acidosis, Renal Tubular Acidosis

Question 20

Hypokalemia with low Urine K and alkalosis?

Answer 20

Vomiting, NG suction

Question 21

Hypokalemia with low Urine K and acidosis?

Answer 21

Lower GI loss of K and HCO3-, laxatives, diarrhea

Question 22

Beta-Blocker’s effect on K?

Answer 22

Hyperkalemia

Question 23

Treatment for hyperkalemia?

Answer 23

1) reverse cellular Effect —— Ca administration
2) Shift K into cells ——- Insulin, beta-agonist,
3) Increase K Excretion —— Loop diuretics, kayexalate, hemodialysis