Nephrology - Electrolytes Flashcards
1
Q
Hyponatraemia
A
- Addison’s disease, hypothyroidism
- burns
- liver cirrhosis, heart failure
- vomiting, diarrhoea
- SIADH
- psychogenic polydipsia
Drugs
- sodium valproate
- carbamazepine
- sulfonylureas
- loop diuretics
- thiazides
2
Q
Causes of SIADH
A
Central nervous system
- Head injury
- Cerebral neoplasm
Respiratory system
- Small cell lung carcinoma (SCLC)
- Pneumonia (Legionnaire’s is the college favourite)
Drugs
- NSAIDs,
- Tricyclic antidepressants,
- SSRI,
- Haloperidol.
3
Q
Causes of hyponatremia with low urine sodium (<10 meq/L)
A
- Dehydration
- Vomiting
- Diarrhea
- Sweating and other skin losses
4
Q
Causes of hyponatremia with high urine sodium (>10 meq/L)
A
- Diuretics
- ACE inhibitors
- Addison disease
5
Q
Hyperkalemia (drugs)
A
- amiloride
- ciclosporin
- angiotensin II receptor blockers
- spironolactone
- heparin
- Tacrolimus
6
Q
Hypokalemia with hypertension
A
- Cushing’s syndrome
- Conn’s syndrome (primary hyperaldosteronism)
- Liddle’s syndrome (similar to hyperaldosteronism)
- 11-beta hydroxylase deficiency*
7
Q
Hypokalaemia without hypertension
A
- GI loss (e.g. Diarrhoea, vomiting)
- Diuretics
- Renal tubular acidosis (type 1 and 2)
- Bartter’s syndrome
- Gitelman syndrome
8
Q
Hypomagnesaemia
A
- loop and thiazide diuretics
- cisplatin,
- aminoglycosides,
- amphotericin B,
- cyclosporine
- hungry bone syndrome following parathyroidectomy
9
Q
Hypophosphatemia
A
- Alcohol Excess
- Acute Liver Failure
- Diabetic Ketoacidosis (DKA)
- Insulin Administration for Severe Hyperglycemia
- Refeeding Syndrome
- Primary Hyperparathyroidism
- Osteomalacia
- Hungry Bone Syndrome (post-parathyroidectomy)
- Respiratory Alkalosis
- Chronic Diarrhea
- Vitamin D Deficiency
10
Q
Hyperphosphatemia
A
- Hypoparathyroidism,
- hypocalcemia,
- renal failure,
- rhabdomyolysis,
- tumor lysis
11
Q
1) Hypercalcemia
2) Hypercalcemia due to cancer
A
- thiazides
- Addison’s disease, thyrotoxicosis, primary hyperparathyroidism, acromegaly
- vitamin D intoxication
- milk-alkali syndrome
- dehydration
- sarcoidosis
Malignancies:
- Squamous cell carcinomas arising in the lung or the head and neck
- Multiple myeloma
- Breast carcinoma
- T-cell lymphoma/leukemia
- Renal cell carcinoma
- Hepatocellular carcinoma
- Bone metastasis
12
Q
Hypocalcaemia
A
- magnesium deficiency
- vitamin D deficiency
- chronic kidney disease
- rhabdomyolysis
- pseudohypoparathyroidism
- hypoparathyroidism
Note: Both hyper- and hypomagnesemia can cause hypocalcemia.
13
Q
Causes of hypernatraemia
A
- dehydration
- osmotic diuresis e.g. hyperosmolar non-ketotic diabetic coma
- diabetes insipidus
- excess IV saline
14
Q
Causes of low calcium and high phosphate
A
- Chronic renal failure
- Hypoparathyroidism
- Pseudohypoparathyroidism
- Magnesium deficiency*
- Rhabdomyolysis
* Due to end-organ resistance to the effects of PTH
15
Q
Causes of pseudohyponatremia
A
- severe hypertriglyceridemia,
- diabetic ketoacidosis,
- plasma cell dyscrasia, such as in patients with multiple myeloma
- obstructive jaundice
