Flashcards in 5a Deck (110)
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61
what mineral should be checked with refractory hypoK and hypoCa
magnesium
62
EKG changes of hyperK
spiked T waveprolonged PR intervalbradycardiawidened QRSdisappearance of P wavesV fib/asystole
63
general clinical signs of hypoK
< 3 muscle weakness, arrythmias2 rhabdomyolysis<2 respiratory muscle paralysis
64
classical clinical signs of hypoK in cats
cervical ventroflexionstiff stilted gaithindlimb weaknessplantigrade stance
65
what effect does low K have on pancreatic islet cells
low K impairs insulin release from beta pancreatic cells
66
treatment of hypo K
K supplementationKCl or KPhosDO NOT EXCEED 0.5 mEq/kg/hr
67
causes of hyperK
decreased renal excretion (obstruction, uroab, oligo/anuric renal fail)GI dz--whipwormsChylothoraxdrugs (ACE inhibits, NSAIDS, K sparing diuretics, heparin)Translocation (acidosis, tumor lysis syndrome)increased intakePseudohyperKAddisons
68
define pseudo hyper K
occurs as a result of severely elevated WBC (>100,000)hemolysis ( ESS, Akitas--with hi IC K)thrombocytosis
69
most common cause of hyper K
impaired renal excretion
70
what syndrome occurs if serum Na increases too fast
central pontine myelinosis(demyelination)
71
T/F Boag JVIM 2005linear FB (not discrete FB) were associated with low Na, Low Cl and metabolic alkalosis
Truelinear FB (not discrete FB) were associated with low Na, Low Cl and metabolic alkalosis
72
most clinically relevant adverse effect of hyper K
decrease in RMP (makes it more negative)more negative (less than threshold potential)therefor cannot depolarize
73
tx hyper K
K deficient fluidsCa gluconate (0.5-1 ml/kg SLOWLY)Dextrose/InsulinCatecholamines --Beta2 agonist (albuterol)Na bicarbHemodialysis
74
Mx of calcium gluconate for treatment of hyperK
does not alter K levelsraises threshold membrane potential to restore cell excitability
75
where is 99% of Ca found
hydroxyapatite of bone
76
forms of calcium and which is most active
ionized, protein bound, chelatedionized is most active; doesn't always correlate w other forms
77
T/Fhypoalbuminemia affects total body Ca levels
true but NOT active ionized form
78
three hormones regulating Ca homeostasis
calcitonin--senses hi Ca, GOAL to lower Cavitamin D (cholecalciferol)--aims to incr Caparathyroid hormone--senses low Ca. GOAL to incr Ca
79
3 body systems involved in Ca homeostasis
boneGIkidney
80
PTH ROLE
senses low Caincr Ca from bone, incr resorption from kidneyactivates vit D from kidney (incr Ca absorption from gut)
81
Calcitonin role
senses hi Ca, GOAL to lower Cainhibits bone resorption and release of Ca
82
causes of hypoCa
decr PTH release ( hypoPTH, postopthyroidectomy/PTectomy, suppression from chronic hyperCa, hypoMg)decr vit D (renal failure, malabsorption, liver insufficiency)Chelation (eclampsia, UT obstruction, saponification-pancreatitis, anticoag in blood transfusions, ethylene glycol))Critical illnesshypoAlb (does not change ionized, only total)
83
mechanism of acute/chronic renal failure on bit D synthesis
renal failure decreases the ability of kidney to convert25-hydroxycholecalciferol to to vit D (cholecaciferol)
84
clinical signs of hypoCa
muscle tremors, hyperexcitability, restless, facial rubbing, stiff, seizures, hyperthermia, vomiting
85
tx hypoCa
calcium gluconate 0.5-1.0 ml/kg slowly 10-20 minwatch ECG for bradyarrythmias
86
causes of hyper Ca
G (granulomatous dz)O (osteoclastic dz/osteomyelitis/osteoporosis)S (spurious)H (hyperPTH--primary or secondary)D (vit D toxicosis--cholecalciferol toxicosis)A (Addisons)R (renal failure)N (neoplasia--AGAC, lymphoma, MM, mets--carcinomas; nurtritional secondary renal hyperPTH)I (iatrogenic, idiopathic)T (toxins)
87
how does malignancy lead to hyper Ca
paraneoplastic syndromelymphoma, anal sac adenocarcinomaPTH-related peptide synthesismost common cause of hyper Ca in DOGS
88
most common cause of hyper Ca in cats
IDIOPATHIC
89
tx of hyperCa
Ca free fluids---NaCl diuresisloop diuretic--promotes calciuresis furosemideGCCBisphosphonatesCalcitoninCa channel blockersNabicarbdecr calcium in diet
90
