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Year 4 > Biochem > Flashcards

Biochem Flashcards

1
Q

What are potassium and sodium required for

A

membrane potential for muscle and nerve function

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2
Q

What is the normal range for potassium

A

3.5-5.5

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3
Q

What are the three types of causes for hyperkalaemia

A
  • pseudohyperkalaemia
  • renal causes
  • transcellular potassium shift
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4
Q

What might cause transcellular potassium shift

A
  • insulin deficiency

* acidosis/alkalosis

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5
Q

What is the main concern in hyperkalaemia?

A

myocardial hyperexcitability which can cause v-fib and cardiac arrest

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6
Q

What is the treatment for emergency hyperkalaemia

A
  • calcium gluconate

* actrapid (insulin)

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7
Q

Why do you give calcium gluconate for hyperkalaemia

A

To protect the heart

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8
Q

Why do you give actrapid

A

insulin forces K+ intracellularly

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9
Q

What would cause you to give hyperkalaemia treatment?

A
  • K+ >6.5

* ECG changes

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10
Q

metabolic (acidosis/alkalosis) may cause hyperkalaemia

A

metabolic acidosis may cause hyperkalaemia

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11
Q

which system regulates potassium levels

A

renin-angiotensin-aldosterone

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12
Q

What ECG changes might be seen in hyperkalaemia

A
  • tall tented T waves

* short QT interval

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13
Q

When can you give potassium as a stat bolus

A

never

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14
Q

What are symptoms of hypokalaemia

A
  • weakness and malaise
  • muscle dysfunction
  • paralysis
  • arrhythmias
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15
Q

What treatment should be given for hypokalaemia

A
  • oral K+ (sando-K)

* IV potassium infusion

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16
Q

What is the max speed of IV potassium

A

15-20mmol/h

17
Q

What are the three classifications of hyponatraemia

A
  • hypovolaemic
  • normonvolaemic
  • hypervolaemic
18
Q

What is hypovolaemic hyponatraemia

A

large Na+ losses and slightly less water losses

usually diarrhoea or burns etc

19
Q

What is normovolaemic hyponatraemia

A

increased water loss with normal sodium

20
Q

What are causes of normovolaemic hyponatraemia

A
  • adrenal insufficiency
  • polydipsia/potomania
  • SIADH
  • hypothyroidism
21
Q

What will urine be like in SIADH?

A

concentrated

22
Q

What are is hypervolaemia hyponatraemia

A

increased fluid retention with small increase in sodium retention

oedema causes circular volume loss which causes ADH release and aldosterone release which both cause water reabsorption (and some Na+ reabsorption)

23
Q

What are causes of hypervolaemia hyponatraemia

A
  • congestive heart failure
  • cirrhosis
  • nephrotic syndrome
24
Q

What are symptoms of hyponatraemia

A
  • nausea and vomiting
  • muscle cramps
  • cerebral oedema
25
Q

What are some causes of hypocalcaemia?

A
  • pseudohypocalcaemia (eg hypoalbuminaemia)
  • hypoparathyroidism
  • CKD
  • rhabdomyolysis
26
Q

what hormones regulate calcium

A
  • PTH
  • calcitriol
  • calcitonin
27
Q

what does elevated urea indicate

A

dehydration

28
Q

what are symptoms of hypercalcaemia

A

stones, bones, groans and psychic moans

29
Q

What ECG changes are seen in hypercalcaemia

A

shortened QT interval

30
Q

What treatment should be given for hypercalcaemia

A
  • correct dehydration
  • bisphosphonates
  • treat underlying cause
31
Q

What are some causes of hypercalcaemia

A
  • hyperparathyroidism
  • malignancy
  • disorders that cause increased bone turnover
32
Q

hypercalcaemia and hypophosphataemia indicates what?

A

hyperparathyroidism

33
Q

what are symptoms of hypocalcaemia

A
  • cramps
  • spasms
  • seizures
  • Trousseau’s sign
  • paraesthesia
34
Q

What is Trousseau’s sign

A

Applying a blood pressure cuff to the arm causes carpo-pedal spasm

35
Q

What ECG changes are seen in hypocalcaemia

A

prolonged QT interval

36
Q

What is treatment for hypocalcaemia

A

oral calcium (calcichew) or IV calcium gluconate

37
Q

What are the most common causes of hypomagnaesemia

A

malnutrition/diarrhoea

Year 4 (13 decks)

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