Chloride and Potassium - Ex 5 Flashcards

1
Q

Hypochloremia (corrected) - Diff 2

A
  1. Loss of Cl
    - high gastric vomiting –> loss of high chloride content fluid
    - Loop or thiazide diuretics: excessive chloride loss from kidneys
  2. Chronic respiratory acidosis
    - chloride is lost through kidney (NH4Cl-)
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2
Q

Hyperchloremia

A

Rare - not going into it

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3
Q

Potassium metabolism

A
  • Principal cation of the ICF
  • Specific roles
  • membrane potential
  • cardiac rate and rhythm
  • renal sodium handling (e.g. K out, Na in)
  • Acid-base balance

***K is super important!! Needs to stay within strict reference interval

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4
Q

General disorders of Potassium

A

*Not as affected by water

  • Main effects
    1. Redistribution
    2. Inc or dec intake
    3. Inc or dec excretion
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5
Q

Acidosis

A

K+ goes from ICF to ECF

*not always predictable

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6
Q

Alkalosis

A

K+ goes from ECF to ICF

*not always predictable

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7
Q

Insulin & K+

A

Insulin helps K go into cells

DM –> insulin deficiency –> animal can become hyperkalemic

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8
Q

Hypokalemia - Redistributional 3

A
  1. Alkalosis
    - metabolic or respiratory
  2. Insulin
    - if you give insulin you risk making animal hypokalemic
  3. Excitement
    - epinephrine
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9
Q

Hypokalemia - Absolute 5

A
  1. Decreased intake
  2. Anorexia
    - seen in ruminants
  3. Diarrhea (MOST COMMON)
    - increased load of Na to colon
    - Na is absorbed –> K is excreted
  4. Vomiting
  5. Renal loss
    - Na avidity in dehydration, K lost in cation exchange
    - Loop diuretics: inc tubular flow
    - cats with CRF
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10
Q

Hypokalemia - large animals 2

A

Saliva is high in K

Equine sweat is relatively high in K

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11
Q

Hypokalemia - CS

A

Generalized muscle weakness
- “Plantigrade” stance

Cardiac arrhythmias

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12
Q

Hyperkalemia - Redistributional 2

A
  1. Metabolic acidosis**
    - protons enter the cells
    - K exits to maintain intracellular electroneutrality
  2. Insulin deficiency: DM
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13
Q

Pseudohyperkalemia

A
  1. Hemolysis
    - in vitro if serum is left on clot
    - Horses(!!), pigs, some dogs (Akitas)
  2. Thrombocytosis (rare)
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14
Q

Hyperkalemia - Absolute 3 main

A
  1. Metabolic acidosis
    - redistribution first, then dec secretion
  2. Renal failure***
    - terminal chronic
    - severe acute (anuric or oliguric)
  3. Uroabdomen***
    - urine is high in K –> leaks into abdomen –> equilibrates
  4. Hypoadrenocorticism***
    - Aldosterone is responsible for excretion of K and absorption of Na –> when aldosterone is missing this is reversed
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15
Q

Hyperkalemia - Uroabdomen

A
  • Urine is high in K
  • K diffuses through mesothelium

Result: hyperkalemia, hyponatremia, hypochloremia

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16
Q

Hyperkalemia - Hypoadrenocorticism

A
  • Addison’s Dz
  • deficiency of mineralocorticoids
  • mineralocorticoids stimulate K excretion in exchange for Na retention

Result: hyperkalemia, hyponatremia, hypochloremia