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Endocrinology - 2nd year > Calcium and other electrolye Disorders > Flashcards

Calcium and other electrolye Disorders Flashcards

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1
Q

acidosis ____ ionized Ca

A

increases

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2
Q

alkalosis ____ ionized Ca

A

decreases

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3
Q

calcium lives in the _____.

A

blood

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4
Q

ionized Ca is the _____ form.

A

bioactive

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5
Q

Normal response to low calcium in body?

A

Parathyroid –> PTH –> liver and renal tubules –> increase Ca absorption, P secretion
PTH –> bone –> osteoclast release of Ca and P
Vit D ingested –> liver –> kindey –> 1,25-hydroxycholecalciferol –> SI –> increase Ca and P absorption

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6
Q

High PTH?

A

High Ca and low P

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7
Q

Hypervitaminosis D?

A

High Ca and P

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8
Q

PTH tumor + kidney failure?

A

start with High Ca, low P –> tubules start to fail –> p retention —> high Ca and P

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9
Q

causes of hypercalcemia?

A 
malignancy #1
primary hyperPTH #2
osteolytic metastasis
hyperVitD
granulomatous disease 
iodiopathic in cats (responds to pred)
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10
Q

hypercalcemia signs?

A 
anorexia
vomiting
depression
weakness
PD/PU
dehydration
abdominal discomfort
constipation
urinary calculi
"not feeling well" patient
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11
Q

four criteria for automatic hospital emission?

A

anorexia, vomiting, depression, and weakness

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12
Q

hypercalcemia work up includes rectal exam, why?

A

anal gland carcinomas are the more common cause of hypercalcemia of malignancy in the dog

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13
Q

PTH level patterns

A

Increase PTH with primary and renal secondary hyperPTH

Can have low PTH with hypercalcemia of malignancy

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14
Q

renal hyperPTH

A

chronic pyelonephritis common

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15
Q

primary PTH tumor

A

high Ca
low P
Normal/high PTH

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16
Q

hypercalcemia of malignancy

A

high Ca

low PTH

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17
Q

hypercalcemia treatment goals?

A

correct dehydration**
promote calciuresis
inhibit bone resoption
treat underlying dz

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18
Q

hypercalcemia specific treatments?

A

NaCl IV fluids
glucocorticoids (AFTER FNA)
bisphosphonates and thyrocalcitonin inhibit osteoclasts
plicamycin inhibits neoplasia

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19
Q

hypervitaminosis D treatment?

A

steroids (glucocorticoids decrease Gi absorption of Ca and P)
IV saline
+/- calcitonin

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20
Q

hypocalcemia causes?

A

primary hypoPTH
postpartum lactation (eclampsia)
hyperP (Acute)
hypoVitD (rare)

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21
Q

primary hypoPTH

A

hypoCa and hyperP

natural onset

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22
Q

main clinical disorder of hypocalcemia?

A

neuromuscular irritability!

muscle weakness, twitch, tetany, seizure

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23
Q

Fleet enema syndrome?

A

giving enema in obstupated animal, solution stays in colon and Ca and P are absorbed into the blood.
The hyperP precipitates the Ca and causes hypoCa –> seizure
DONT USE FLEET ENEMA IN SAs

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24
Q

hypocalcemia treatment?

A

calcium gluconate IV

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25
hypovitD treatment?
supplementation with Vitamin D2, DHT, or Calcitriol (chronic rx)
26
Only __% of K is in the EXC, the rest is INC
2%
27
K body distribution
Most in muscle cells, also liver and RBCs | most that goes in, comes back out
28
Acidosis _____ EXC K
increases (INC ---> EXC)
29
Alkalosis _____ EXC K
decreases (EXC --> INC)
30
hyperK leads to sustained _____.
depolarization
31
hypoK leads to sustained ____.
hyperpolarization
32
The main sign for both hyper and hypoK is ___.
muscle weakness
33
Changes in ECG with changing K
As K increases, atrial standstill ---> v fib | As K decreases, tachycardia ---> v fib
34
HypoK clinical signs
<2.5 K MUSCLE WEAKNESS lethargy, confusion, PU/PD (hypoK nephropathy), ileus, anorexia unpredictable ECG changes
35
Causes of hypoK
``` movement into cells (insulin) GI loss (v/d) - can also cause hyperCl and metabolic acidosis Renal loss - cats with CKD ```
36
ANY ANIMAL THAT WON'T STOP VOMITING BUT DOESN'T HAVE DIARRHEA, what are you worried about?
Obstruction or pancreatitis
37
HypoK treatment?
KCl or KPhos (is also low P)
38
CRI K
Give at low rate unless trying to die, then X3 + close ECG monitoring
39
HyperK affects on ECG are exaggerated by?
HypoNa
40
HyperK signs?
MUSCLE WEAKNESS | Cardiac excitation and conduction abnormalities
41
bradycardia + no p waves =?
atrial standstill
42
HyperK main mechanisms?
too much intake impaired excretion - AKF, Addisons shifting out of INC to EXC severe exercise - rhabdomyolysis --> renal tube injury
43
False hyperK?
When blood is allowed to clot in serum | When animals have high PLT, cushings
44
HyperK treatment?
``` Ca Gluconate!! To save heart, not lower K Bicarb - EXC --> INC but not reliable Insulin diuresis dialysis Beta agonists (EXC --> INC) ```
45
Most Na is in which space?
EXC
46
HypoNa
BIG PROBLEMS <120
47
HypoNa causes?
water gain - common | sodium loss - uncommon (Addison's)
48
Acute HypoNa will affect the _____ the most!
Brain EXC Na decreased --> Water to INC --> brain --> edema Can cause by giving dextrose 5% in water (D5W)
49
HypoNa signs
weakness, apathy, dementia, stupor/coma (bad), absence of thirst, decreased skin elasticity, hypotension, hypothermia, shock, seizures, myoclonus
50
HypoNa classifications
Eusmolar Hyperosmolar Hypoosmolar
51
HypoNa is commonly ____.
hyperosmolar hypovolemic
52
2 causes of acute hypoNa
``` increase intake (PPD, iatrogenic) decreased water excretion (too much ADH in liver dz/lung carcinoma) ```
53
D5W
Isotonic, no Na in it dilutes EXC use with early CHF can cause hypoNa
54
With chronic hypoNa, do not exceed rate of correction of serum Na by more than_________.
8-12 in 24 hours
55
Giving ____ while treating hypoNa with NaCl, helps avoid brain complications
furosemide
56
Addison's dz may require ____ replacement of Na.
slow
57
What happens if you correct Na too fast?
Osmotic demyelination of brain
58
Correct slow, if it occurs slow
Correct fast, if it occurs fast
59
HyperNa
>170 see problems | Hypertonic encephalopathy
60
HyperNa main causes?
Na gain- uncommon | H2O loss - common (dehydration)
61
HyperNa signs?
``` fever nausea, vomiting seizures coma array of neuo signs hypotension tachycardia oliguria ```
62
HyperNa types?
hypovolemic - renal/GI (v/d) hypervolemic - due to hypertonic saline treatment euvolemic - DI
63
HyperNa treatment
``` stop water diuresis by giving ADH to DI patient STOP hypertonic fluid CRI Give .45% NaCl or D5W IV If acute, can fix fast If chronic, must fix slowly ```
64
ECC priorities?
Volume, pH, then electrolyte correction

Endocrinology - 2nd year (8 decks)

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