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Renal system > Assorted Electrolytes > Flashcards

Assorted Electrolytes Flashcards

(90 cards)

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1
Q

what are the main electrolytes?

A 
Na+
K+
Ca2+
Mg2+
PO42-
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2
Q

homeostasis

A

requires the maintenance of water, pH and electrolytes within a narrow range to be conducive to life

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3
Q

1/3 reduction in K+

A

paralysis

unable to generate APs

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4
Q

1/2 Ca2+

A

tetanic skeletal muscle contractions

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5
Q

main calcium ion location

A

extracellularly

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6
Q

main magnesium ion location

A

intracellular

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7
Q

main phosphate ion location

A

intracellular

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8
Q

Na+

A

determinant in controlling ECF volume and water distribution
kidneys are major route of excretion
changes affect BP and intracellular fluid composition and volume

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9
Q

Na+ in kidney

A

freely filtered in glomerulus

reabsorbed in PCT, LoH and DCT so less than 1% is excreted in urine

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10
Q

homeostasis of plasma Na+

A

ADH secretion due to increased blood osmolality
reduced BP triggers ANP production and RAAS and ADH secretion
act on kidney to promote water and sodium rabsorption

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11
Q

hyponatraemia

A

<135mmol/L

serum osmolality important

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12
Q

isotonic and hypertonic hyponatraemia

A

possible alterations in other plasma components impacting Na+ concentration
high or normal serum osmolality

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13
Q

low serum osmolality

A

hypotonic hyponatraemia

true alteration in sodium concentration

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14
Q

presentation of hypotonic hyponatraemia

A

hypovolaemia
euvolaemia
hypervolaemia

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15
Q

pathophysiology of hypovolaemia

A

decreased water and Na+

excessive renal or extrarenal water and Na+ loss

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16
Q

euvolaemia

A

increased water retention

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17
Q

hypervolaemia

A

presence of oedema or ascites

increase in bodily water and sodium

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18
Q

causes of hypovolaemia

A

from diuretics, vomiting and diarrhoea

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19
Q

causes of euvolaemia

A

due to hypothyroidism

or adrenal insufficiency

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20
Q

causes of hypervolaemia

A

due to heart failure and renal disease

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21
Q

symptoms of hyponatraemia

A

headache
lethargy
dizziness
confusion

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22
Q

intervention for hyponatraemia

A

treat underlying cause

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23
Q

causes of hypernatraemia

A

reduction in bodily water
increased loss of water or decreased intake
rarely sodium gain

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24
Q

hypernatraemia

A

rarer
>145mmol/L
increased plasma osmolality

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25
how can hypernatraemia present
euvolaemia hypovolaemia hypervolaemia
26
patient's at high risk of hypernatraemia
fragile condition restricted access to water - mental health, unconcious, small children impaired thirst perception
27
common causes of hypernatraemia
``` dehydration not drinking enough diarrhoea kidney dysfunction diuretics ```
28
symptoms of hypernatraemia
thirst fever dry mucous membranes restlessness
29
intervention for hypernatraemia
depends on underlying cause
30
K+
forms basis of resting membrane potential
31
sodium potassium pump
3 sodiums moved outside and 2 potassiums moved inside cell
32
resting membrane potential
small leak of potassium to outside of cell until equilibrium reached
33
what maintains K+ balance?
kidneys
34
renal handling of K+
freely filtered through glomerulus | reabsorbed along tubules - only 10% excreted
35
which cells are involved in reabsorption of K+
principal cells intercalated cells in DCT and collecting duct
36
activity of intercalated cells
K+/H+ transport with ATPase pump | K+ reabsorbed and H+ excreted stimulated by acidosis and low K+ concentration
37
activity in principal cells
ENaC coupled channels reabsorb Na+ and secrete K+ stimulated by aldosterone, increased K+ conc and alkalosis and increased tubular flow
38
hypokalaemia
due to increased potassium uptake into cells or increased elimination of K+
39
causes of hypokalaemia
``` alkalosis diarrhoea vomiting renal loss diuretics reduced reabsorption of Na+ insulin administration hyperaldosteronism ```
40
symptoms of hypokalaemia
``` decreased neuromuscular excitability - muscle weakness decreased tone in smooth muscle delayed ventricular repolarisation bradycardia AV block ```
41
clinical features of hypokalaemia
membrane hyperpolarisation
42
parameters for hypokalaemia
<3.5mmol/L
43
intervention for hypokalaemia
oral or slow IV K+ administration
44
hyperkalaemia
movement of K+ from intracellular to extracellular environment or decreased excretion
45
parameters for hyperkalaemia
>5.3mmol/L
46
common causes of hyperkalaemia
tissue damage acidosis aldosterone impairment
47
symptoms of hyperkalaemia
``` increased neuromuscular irritability restlessness intestinal cramping diarrhoea loss of muscle tone and paralysis in severe cases ```
48
clinical features of hyperkalaemia
ECG changes ventricular fibrillation hyperventilation
49
interventions for hyperkalaemia
diet or medication adjustment insulin and glucose administration Ca2+ to treat ECG changes
50
danger of hyperkalaemia
arrhythmias causing cardiac arrest and death
51
increase in blood calcium levels
calcitonin released by thyroid binds to receptors on osteoblast increases osteoblast activity - Ca2+ deposition and reduced phosphate ions in ECF increased excretion of Ca2+
52
decrease in blood calcium levels
PTH released and binds to receptors on osteoblasts causing increased release of Ca2+ and phosphate ions into ECF increased reabsorption of calcium and increased excretion of phosphate activates production of vitamin D
53
vitamin D
increases Ca2+ absorption and phosphate absorption
54
hypocalcaemia
<2.1 mmol/L
55
causes of hypocalcaemia
``` nutritional deficiency vit. D deficiency hypoparathyroidism kidney failure hyperventilation ```
56
symptoms of hypocalcaemia
``` confusion muscle spasm paraesthesia drowsiness coma ```
57
clinical features of hypocalcaemia
ECG prolonged QT interval
58
intervention for hypocalcaemia
long term oral calcium and/ or vitamin D IV calcium in severe cases phosphate and magnesium ion monitoring
59
hypercalcaemia
>2.6mmol/L
60
causes of hypercalcaemia
hyperparathyroidism excess vit. D malignancy in bone
61
symptoms of hypercalcaemia
``` stones bones moans groans fatigue muscle weakness ```
62
clinical features of hypercalcaemia
shorten QT segment depressed T waves\hypertension kidney stones
63
interventions for hypercalcaemia
reduce dietary intake of Ca2+ and vit. D | medication or surgery to reduce PTH
64
phosphate role
``` essential part of biochemical systems - bones, buffers strongly associated with Ca2+ and Na+ phospholipids ATP regulate enzyme activity ```
65
hypophosphataemia
>0.4mmol/L
66
causes of hypophosphataemia
reduced intestinal absorption (low vit. D or alcohol abuse) primary hyperparathyroidism osteomalacia rickets
67
symptoms of hypophosphataemia
muscle weakness - diaphragm and cardiac contractility confusion hallucinations convulsions
68
clinical features of hypophosphataemia
left shift of oxy-haem dissociation curve - reduced O2 transport arrhythmias heart failure
69
intervention for hypophosphataemia
oral phosphate therapy | IV phosphate
70
hyperphosphataemia
>1.5mmol/L
71
causes of hyperphosphataemia
chronic kidney disease
72
symptoms of hyperphosphataemia
hypocalcaemia | due to calcium phosphate formation which precipitates in lungs, kidneys and joints
73
clinical features of hyperphosphataemia
similar to hypocalcaemia
74
intervention for hyperphosphataemia
reduce dietary phosphate decrease intestinal reabsorption dialysis
75
role of magnesium ions
``` enzymatic reactions needed for ATPase gene transcription bone remodelling neuromuscular stability ```
76
location of magnesium
intracellular mostly in bones some in muscle and soft tissue
77
magnesium regulation
by kidney, reabsorbed in loop of Henle mainly
78
magnesium disorders
often associated with other electrolytes - Na+/K+
79
hypomagnesaemia
<0.7mmol/L
80
causes of hypomagnesaemia
``` malnutrition defective gut absorption excessive gut or urinary loss alcoholism diuretics ```
81
symptoms of hypomagnesaemia
``` irritability tremor ataxia carpopedal spasm hyperreflexia confusion hallucinations convulsions ```
82
clinical features of hypomagnesaemia
progressive QRS complex widening PR interval prolongation flattened T waves
83
intervention for hypomagnesaemia
oral or IV replacement therapy | correct underlying cause
84
hypermagnesaemia
>1mmol/L
85
hypermagnesaemia causes
kidney disease - chronic or acute | magnesium containing laxatives or antacids
86
symptoms of hypermagnesaemia
``` depressed skeletal muscle contraction and nerve functions hyporeflexia proceeding narcosis respiratory paralysis cardiac conduction defects ```
87
clinical features of hypermagnesaemia
ECG changes - prolonged QT interval bradycardia heart blocks
88
intervention for hypermagnesaemia
if renal function is normal - magnesium therapy stopped | if not peritonael dialysis or haemodialysis
89
heart failure patients
at risk of hyperkalaemia due to mineralocorticoid blockers for treatment
90
raised creatinine
can be secondary to hypercalcaemia due to calcium deposits in kidney

Renal system (17 decks)

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