Potassium, Acid-Base Flashcards
What is the definition of resolution of DKA?
AG normalization, normal serum ketones (specifically, beta-hydroxybutyrate)
why is urine alkalinization used to address salicylate toxicity?
an alkaline pH makes an acid ionized, the ionized drug cannot be reabsorbed by the renal tubule & the ionized drug cannot get into cells. the drug gets excreted into the drug
match the ingestion with the acid
1. methanol
2. ethylene glycol
3. toluene
a. hippuric acid
b. formic acid
c. oxalic acid
methanol = formic acid
ethylene glycol = oxalic acid
toluene = hippuric acid
what acid base disorder is caused by topiramate?
NAGMA.
by inhibiting CAI, it can cause pRTA
which should be replaced first when both K & Mg are low?
replace Magnesium first. low Magnesium can cause K wasting
what is the treatment of ethylene glycol or antifreeze poisoning?
Fomepizole.
It inhibits alcohol dehydrogenase & prevents the metabolism to oxalic acid, acidosis, & crystal-induced AKI.
Continued until alcohol level is < 20mg/dl or <10 mg/dL if with end-organ damage
what is the equation for calculated osmolality?
2Na + glu/18 + BUN/2.8
what can cause a patient to have low K, nL or low BP, high urine Cl, high urine Ca?
Bartter’s or loop diuretics
Is urine ketone measurement important in following DKA management?
No.
urinary ketones may still be high despite resolution of DKA.
match Gitelman and Bartter syndromes with these findings:
hypercalciuria, hypocalciuria, hypomagnesemia
Bartter (loop like): hypercalciuria,
Gitelman (thiazide like): hypocalciuria, hypomagnesemia
in dRTA, is the urine anion gap positive or negative? is the uOsm gap > 150 or < 150 mOsm/kg H2O?
dRTA: urine anion gap is (+), uOsm gap is < 150
Renal potassium retention is suggested by what ratio of urine K:crea?
Urine K:crea < 15 meq/g
A urine Cl < 10 with hypokalemia should raise concerns for
Surreptitious vomiting
name 2 drugs that can cause both pRTA and dRTA
topiramate and zonisamide
Name 5 drugs a/w dRTA?
topiramate, zonisamide, lithium, amphotericin B, toluene