Clinical Tests 1 Flashcards
Why do ACE inhibitors increase potassium levels?
Aldosterone facilitates production of K (RAAS)
what should you check in patients with HTN
Potassium levels
v. high can cause heart failure, arrhythmia
Signs of hypokalaemia (low potassium)?
Muscle cramps/spasms/aches
Fatigue/Weakness
Confusion
Cardiac arrythmia
What is indicative eGFR for end stage kidney function?
Below 15
Severe eGFR indicator?
15-29
What do you look for in urinalysis test?
Proteins
Urea
WBC / RBC
Ketones
Glucose
Presence of protein, urea and glucose in urine indicative of?
Impaired filtration and excretion of kidney
Renal impairment / damage
Range for Sodium (Na) ?
135 - 145 mmol/L
Range for Potassium (K) ?
3.5 - 5 mmol/L
Range for CRP?
< 5 mg/L
Why don’t we give both BB and CCB?
Both slow down HR so cause bradycardia
Implications of losing urea in urine? I.e. Low urea in the bloodstream
Loss of nitrogen
Nitrogen used in DNA and AAs which form proteins that make/repair hair, skin and muscles.
What is the underlying cause of hyponatraemia
Impaired ability of kidneys to excrete dilute urine
- poor renal function
Symptoms of hyponatraemia?
Confusion
Headache
N+V
Muscle cramps
Chronic cases: Seizure, Cerebral oedema
Treatment of hypovolaemic hyponatraemia?
Rehydrate using NaCl 0.9% infusion (Hartmanns)
Treatment of hypervolaemic hyponatraemia?
Restrict fluid and salt intake
Consider diuretics (to reduce volume)
Treatment of euvolaemic hyponatraemia?
Reassess causative medicines
If SIADH then fluid restriction
Treatment of MILD hyperkalaemia?
Furosemide 40-80 mg (non K+ sparing diuretic) (loop)
Calcium resin (binds to K+ to aid its excretion by kidney)
Treatment of MODERATE hyperkalaemia?
Salbutamol/Albuterol high dose
Insulin IV (short acting)
Why must you take diuretics (esp. K+ sparing (w/o loss of K+)) with digoxin?
Digoxin causes electrolyte imbalance (inhibits Na/K exchange pump)
Increases risk of digoxin toxicity due to NTW
