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Clin Med II - Exam 4 > Schoenwald - Electrolytes > Flashcards

Schoenwald - Electrolytes Flashcards

1
Q

electrolytes (4)

A

Na

K

Cl

CO2

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2
Q

main regulator of water and Na

A

kidney

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3
Q

primary circulating (extracellular) cation

A

Na

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4
Q

fxn of Na

A

neuromuscular fxn

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5
Q

serum levels of Na are a balance btw (2)

A

dietary intake

renal excretion

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6
Q

major contributor to plasma osmolality

A

Na → indicator of free body water

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7
Q

osmolality is useful in evaluating (2)

A

hyponatremia

ADH related illnesses

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8
Q

osmolality decreases w. __

and increases w. __

A

overhydration

dehydration

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9
Q

what hormone regulates body water and osmolality

A

adh

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10
Q

adh is stimulated by (3)

A

increased osmolality

hypovolemia

thirst

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11
Q

where does adh act

A

collecting tubule → increases permeability → increases water reabsorption → more concentrated urine

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12
Q

serum osmolality is elevated in (5)

A

hypernatremia

hyperglycemia

ketosis

dehydration

diabetes insipidus

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13
Q

serum osmolality is decreased in (2)

A

overhydration

SIADH

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14
Q

common cause of SIADH

A

drugs

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15
Q

SIADH leads to __ water absorption

and __ sodium levels

A

increased

decreased

lose Na in urine

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16
Q

what syndrome is associated w. inadequate amt of adh

A

diabetes insipidus

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17
Q

sx of diabetes insipidus

A

increased thirst

large volume of dilute urine

hypernatremia

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18
Q

urine osmolality measures

A

dissolved particles in urine

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19
Q

t/f: urine osmolality is more specific than specific gravity

A

t!

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20
Q

urine osmolality evaluates

A

ability of kidney to concentrate urine

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21
Q

urine osmolality is increased in (2)

A

siadh

chf

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22
Q

urine osmolality is decreased in (2)

A

diabetes insipidus

excess fluid intake

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23
Q

2 types of hyponatremia

A

Na depletion

dilutional

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24
Q

Na depletion hyponatremia is caused by

A

free water loss

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25
Q

dilutional hyponatremia is caused by

A

water intake > water output → renal failure

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26
Q

hyponatremia is usually asymptomatic until it drops to

A

< 120 mEq/L

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27
Q

sx of hyponatremia (3)

A

lethargy

nausea

muscle cramps

cerebral edema

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28
Q

causes of hypernatremia (3)

A

stroke → impaired thirst mechanism

water loss w.o Na loss → burns/fever

dehydration

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29
Q

urine sodium can be measured by (2)

A

spot testing

24 hr urine

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30
Q

urine sodium helps evaluate

A

renal vs nonrenal hyponatremia

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31
Q

increased urine Na can indicate (5)

A

dehydration

diuretics

adrenocortical insufficiency

siadh

ckd

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32
Q

decreased Na can indicate (2)

A

chf

diarrhea

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33
Q

hyponatremia flow chart

A
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34
Q

classifications of volume status

A

hypovolemia

euvolemia

hypervolemia

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35
Q

hyponatremia w. normal osmolality is called

A

isotonic hyponatremia

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36
Q

isotonic hyponatremia is associated w.

A

hyperproteinuria

hyperlipidemia

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37
Q

hyponatremia w. low osmolality is called

A

hypotonic hyponatremia

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38
Q

hyponatremia w. elevated osmolality is called

A

hypertonic hyponatremia

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39
Q

hypertonic hyponatremia is associated w. (2)

A

hyperglycemia

radiocontrast agents

40
Q

hypovolemic hyponatremia is associated w. (3)

A

dehydration

diarrhea

vomiting

41
Q

euvolemic hyponatremia is associated w. (2)

A

siadh

postop hyponatremia

42
Q

hypervolemic hyponatremia is associated w. (3)

A

edema → chf

advanced renal failure

liver ds

43
Q

primary intracellular cation

A

K+

44
Q

fxn of K+

A

cardiac muscle fxn

45
Q

is K+ reabsorbed from kidneys

A

no!

it is excreted

46
Q

why does K+ need to be given IV to pt’s who can not eat

A

it is not reabsorbed by kidneys

47
Q

as __ is reabsorbed

__ is lost

A

Na reabsorbed → K+ is lost

48
Q

sx of hypokalemia (3)

A

malaise

skeletal m weakness

arrythmias

49
Q

ekg findings of hypokalemia

A

flattened or inverted t waves

50
Q

causes of hypokalemia (6)

A

diet

diuretics

burns

glucose administration

licorice

hyperaldosteronism

51
Q

causes of hyperkalemia (6)

A

renal failure

acidosis

diet

ACEI

acute or chronic renal failure

hemolysis

52
Q

in metabolic acidosis, K+ is driven

A

out of the cell

53
Q

sx of hyperkalemia (4)

A

arrythmias

cardiac arrest

numbness/tingling

weakness

54
Q

ekg findings of hyperkalemia

A

peaked t waves

55
Q

most abundant extracellular anion

A

chloride

56
Q

chloride is regulated by __

and exchanged for __

A

proximal tubules

bicarb ions

57
Q

Cl is indirectly regulated by (2)

A

Na
water

58
Q

is Cl test alone helpful

A

no!

59
Q

causes of increased Cl (2)

A

dehydration

metabolic acidosis

60
Q

causes of decreased chloride (3)

A

overhydration

siadh

vomiting

61
Q

what do lytes help us determine (2)

A

acute vs chronic renal failure

fluid therapies

62
Q

mc cause of acute renal failure

A

nephrotoxins → meds

63
Q

t/f arf is usually reversible

A

t!

64
Q

sx of arf (3)

A

n/v

ams

edema

65
Q

prerenal causes of arf (4)

A

hypovolemia

hypotn

chf

renal artery stenosis

66
Q

renal causes of arf (2)

A

nephrotoxins

ai dz

67
Q

postrenal cause of chf

A

obstruction

68
Q

key parameter for renal fxn management

A

GFR

69
Q

__ and

__ are easier to measure than GFR, but are less reliable

A

BUN

Cr

70
Q

aki definition

A

acute increase in SCr 0.5 mg/dl or higher

OR

over 50% of baseline

71
Q

classification for aki

A

rifle

72
Q

rifle criteria: risk

A

SCr increased 1.5 x

OR

GFR > 25% decrease from baseline

73
Q

rifle criteria: injury

A

SCr increased 2x

OR

GFR > 50% decrease from baseline

74
Q

rifle criteria: failure

A

SCr > 3 x

OR

SCr > 4 x w. acute increase > 0.5

OR

GFR decrease > 75% from baseline

75
Q

other labs in evaluation of aki (4)

A

urine Na

Fena (fractional excretion of Na)

urine osmolality

BUN:Cr ratio

76
Q

urine Na: > 20

Fena: < 1%

urine osmolality: 500

BUN:Cr: 20:1

A

prerenal aki

77
Q

urine Na: > 40

Fena: 1-2%

urine osm: 250-300

BUN:Cr: < 15:1

A

intrinsic aki

78
Q

ckd gfr parameters

A
79
Q

in arf, CrCl will be

A

decreased

80
Q

in arf K+ will be

A

elevated → hyperkalemia

81
Q

UA in arf will be positive for (2)

A

protein

blood

82
Q

mild - mod decrease in gfr over time w.o presence of uremic sx

A

chronic renal failure

83
Q

2 mc causes of ckd

A

htn

dm

84
Q

sx of progressed ckd (3)

A

fatigue

malaise

vomiting

85
Q

labs elevated in ckd (2)

A

BUN

Cr

86
Q

__ and

__ are usually normal until advanced ckd

A

UA

lytes

87
Q

primary buffer system of body

A

carbonic acid/bicarbonate system

88
Q

CO2 is regulated by __

bicarb is regulated by __

A

lungs

kidneys

89
Q

equation of ife

A

•HCO3¯+H+«—-»H2CO3«—-»CO2+H2O

90
Q

increase in blood CO2

A

respiratory acidosis

91
Q

decrease in blood CO2

A

respiratory alkalosis

92
Q

increase in blood bicarb

A

metabolic alkalosis

93
Q

decrease in blood bicarb

A

metabolic acidosis

94
Q

what does anion gap tell you (2)

A

lyte balance

acid-base balance

95
Q

what does mudpiles cat stand for

A

reasons for metabolic acidosis:

methanol

uremia

dka

paraldehyde

iron, isoniazid

lactic acidosis

ethanol, ethylene glycol

salicylate/asa

carbon monoxide

aminoglycosides

theophyline

Clin Med II - Exam 4 (20 decks)

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