Phys: Electrolyte Disturbance: Ca, Mg, Phosphate Flashcards

1
Q

Calcium normal range

A

8.5-10

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2
Q

50% of calcium is bound to ______

A

Albumin

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3
Q

Majority of calcium is stored in the __________

A

Bones

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4
Q

Roles of Calcium

A

Coagulation, cell signaling, muscle contraction, neuromuscular transmission

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5
Q

Endocrine regulation of Calcium done by these 2 things

A

Calcitriol and PTH

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6
Q

Hypocalcemia

A

Causes: eating disorders, chelation therapy, low PTH, low vitamin D, tumor lysis

Clinical presentation: NM irritability, parasthesis (oral, perioral, a real) tingling or pin and needles, tenany, hyperreflexia, laryngospasm

ECG: prolonged QT interval

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7
Q

Hypercalcemia

A

Causes: Excess PTH, excess Vit D, Malignancy

Clinical presentation: constipation, fatigue, lethargy, depression, bone pain, kidney stones, anorexia, nausea, vomiting, pancreatitis

Psychiatric: Depression and confusion

EKG: Short QT interval, widened T wave

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8
Q

Renal regulation of Calcium

A

Kidneys excrete Ca in urine and kidneys are involved in forming Vit D

99% of filtered Ca is reabsorbed

Reabsorption of Ca is tightly coupled to Na

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9
Q

What is the major controller of GI calcium absorption?

A

Vitamin D

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10
Q

Ca++ reabsorption is tightly coupled to _______

A

Na+ reabsorption in the PCT and TALH

Only in the distal tubule is the reabsorption of the two ions dissociated

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11
Q

Magnesium normal range

A

1.5-2.0

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12
Q

Mg is a necessary __________ for many enzymed

A

Cofactor

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13
Q

Hypomagnesemia

A

Caused by: alcoholism, malnutrition, Chron’s disease, Whipple’s disease, celiac sprue

Renal Loss: Bartter’s syndrome, Gitelman syndrome, Loop and thiazide diuretics side effect

Clinical presentation: weakness and muscle cramps, CNS-irritability, hallucinations, depression

EKG: Prolonged PR, QRS, and QT. Tornadoes de pointes, complete heart block and cardiac arrest, Cardiac arrythmias

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14
Q

Hypermagnesemia

A

Causes: cell lysis, hemolysis, tumor cell lysis, renal insufficiency

Clinical presentation: weakness, nausea, vomiting (4.0 mEq/L hyporeflexia)

EKG: arrhythmia and asystole
>5 : prolonged AV conduction
>10: complete heart block
>13 Cardiac arrest

Prolonged PR interval, shortened QT

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15
Q

Renal Regulation of Mg

A

Free component is freely filtered and then handled by the nephron almost identically to Calcium

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16
Q

Phosphate normal range

A

2.3-4.8

17
Q

Phosphate

A

Necessary cofactor for many enzymes and is a major intracellular anion

18
Q

Endocrine regulation of phosphate

A

Calcitriol and PTH

19
Q

Hyperphosphatemia

A

Causes: hypoparathyroidism, chronic renal failure, tumor lysis

Clinical presentation: ectopic calcification

20
Q

Hypophosphatemia

A

Causes: alcohol abuse, malabsorption

Clinical presentation: muscle dysfunction, respiratory depression, Rhabdomyolysis

21
Q

90-95% f the total plasma phosphate is filterable at the ___________

A

Renal corpuscle

22
Q

Filtered phosphate is actively reabsorbed in the ________

A

PCT (75-80%)