Acid-Base, Electrolytes Flashcards Preview

ABOMS Medical Assessment (Johnston) > Acid-Base, Electrolytes > Flashcards

Flashcards in Acid-Base, Electrolytes Deck (12)
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1
Q

Diarrhea

Affects on electrolytes

Resulting Acid-Base deragement

A

Diarrhea

  • Hyperkalemia
  • Metabolic acidosis
2
Q

Vomitting

Affects on electrolytes

Resulting Acid-base deragement

A

Vomitting

  • Hypokalemia
  • Elevated bicarb
  • Metabolic Alkalosis
3
Q

Etiologies of respiratory acidosis

Hypo or Hyper ventilation?

COPD or Asthma?

A

Respiratory Acidosis: Etiologies

Hypoventilation

COPD

4
Q

Respiratory Alkalosis: Etiologies

Hyper or Hypoventilation

Asthma or COPD

2 other systemic conditions

1 additional respiratory condition

A

Respiratory Alkalosis: Etiologies

Hyperventilation

Asthma

Liver disease Pregnancy

PE

5
Q

Hyponatremia

  • Subtypes
  • Cause and treatment for each
A

Hyponatremia

Subtypes

  • Hypotonic hypovolemic: Diarrhea, Addison’s, Mass diuresis with loop or thiazide. Tx with fluid resusciation with normal saline.
  • Hypotonic euvolemic: SIADH, polydipsia. Tx with ADH antagonist, treat underlying condition
  • Hypotonic hypervolemic: Liver failure, Heart Failure, Nephrotic syndrome. Tx with fluid restriction
  • Isotonic (or pseudohyponatremia): Hyperlipidemia, Hyperproteinemia. Also, rapid infusion osmotically active particles like glucose, mannitol. Tx with DDAVP.
6
Q

Hypernatremia

  • Subtypes
  • Cause and treatment for each
A

Hypernatremia

  • Hypovolemic: More water loss than sodium loss
    • Renal loss
      • Thiazide Diuresis, Renal Failure
      • Non-ketotic hyperglycemia
    • Non-renal loss
      • Diarrhea
    • Treatment: calculate free water deficit and replace with isotonic fluid, treat underlying condition
  • Euvolemic: Loss of water only
    • Diabetes insipidus. Can be central or psychogenic
    • Tx: DDAVP if central
  • Hypervolemic: More water gain than sodium gain
    • Excess mineralocoticoids, Cushing Syndrome
7
Q

Hypokalemia

  • Renal vs non-renal causes
  • Symptoms
  • Treatment
A

Hypokalemia

Renal

  • Non-potassium sparing diuretics
  • PCNs
  • Magnesium depletion
  • Alkalosis

Non-renal

  • Diarrhea, Vomitting
  • K+ pushed intracellularly (All adrenergics including Beta-2, insulin,

Symptoms generally absent unless <3.0

  • Muscle cramps, lethargy, palpitations, paralysis, U waves on EKG (small wave after T wave)

Treatment:

  • Replete with KCl, Magnesium
8
Q

Hyperkalemia

  • Renal vs non-renal
  • Symptoms
  • Tx
A

Hyperkalemia

Renal

  • Renal failure
  • Meds: ACE-I, ARBs, Potassium sparing diuretics (sprinolactone), NSAIDS

Non-renal (releasing K+ from intracellular)

  • Acidosis
  • Crush injury
  • Meds: Beta-blockers, CCB, succhinylcholine

Symptoms: N/V, weakness, Peaked T waves, Widened QRS, flattened P-waves,

Tx

  • Kayexalate
  • Insulin + dextrose
  • Loop/thiazide diuretic, dialysis
9
Q

Calcium usually excreted in stool or urine?

A

Stool

10
Q

Hypocalcemia

  • Causes
  • Symptoms
  • Treatment
A

Hypocalcemia

  • Hypomagnasemia, Renal failure, Vit D deficiency, hypoparathyroidism, pancreatitis, blood transfusions, rhabdo, hypoalbuminemia
  • Prolonged QT, tetany, seizures, Chvostek sign (flick facial nerve to elicit lip twitch
  • Treatment: IV Ca, oral Ca, Calcitrol
11
Q

Hypercalcemia

  • Causes
  • Symptoms
  • Treatment
A

Hypercalcemia

  • Osteolytic metastasis, malignancy with PTHrP, Paget’s disease, granulomatous disease, multiple myeloma, hyperparathyroidism, thiazide diuretics
  • Bones, Stones, Groans, Moans, Pyschic overtones, fatigue, weightloss, polydipsia, polyurea, death
  • Volume resucitation, Furosemide, Parathyroidectomy, calcitonin, glucocorticoids
12
Q
A