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Flashcards in Electrolyte Disorders Deck (31):
1

Common volume status of hypotonic hyponatremia

  1.  hypovolemic
  2. euvolemic
  3. hypervolemic

2

Hypotonic hypovolemic hyponatremia is charactereized by what? 

  1. Urinary Na values
    1. Una <10mEq/L
    2. Una >20mEq/L

 

3

What will produce a Una<10mEq/L?

  1. hypotonic hypovolemic hyponatremia. 
    1. extra-renal salt loss
      1. dehydration
      2. vomiting
      3. diarrhea
      4. 3rd spacing due to burns, trauma

 

4

What will produce a urinary Na >20mEq/L?

  1. hypotonic hypovolemic hyponatremia. 
    1. renal salt loss
      1. diurectics.
      2. nephropathies. 
      3. Mineralocorticoid deficiency. 
      4. cerebral sodium wasting. 
      5. partial obstruction. 
      6. RTA-IV
      7. ACEI.

 

5

What will cause a hypotonic euvolemic hyponatremia?

  1. clinical picture would describe someone who is not dehydrated.  and a Urinary Na>20mEq/L
    1. SIADH (majority)
    2. psychogenic polydipsia
    3. hypothyroidism
    4. beer potomania
    5. idiosyncratic drug reaction
    6. endurance exercise
    7. adrenocorticotropin deficiency
    8. stress, HIV
    9. idiopathic hyponatremia.

 

 

6

What would indicate a hypotonic hypervolemic hyponatremia?

Urinary Na<10mEq/L. Wiht presentation of edema, ascites, pulmonary edema, heart failure.

7

What are common causes of hypotonic hypervolemic hyponatremia?

  1. Edema
    1. congestive heart failure
    2. liver disease
    3. nephrotic syndrome
    4. advanced kidney disease.

 

8

What are often the main categories to describe hypokalemia?

  1. Reduced dietary intake
  2. Shift of extra-cellular K into the cells. 
  3. Renal K loss
  4. Extra-renal K loss

 

9

What body physiology/characteristics will lead to an intracellular shift of K?

  1. Alkalosis. 
  2. Hihg insulin levels
  3. trauma with adrenergic stimulation (elevate insulin levels)
  4. periodic paralysis
  5. barium intoxication. 

 

10

What are common causes of renal K loss? 

  1. Excessive aldosterone level. 
  2. Low Mg. 
  3. RTA -I/-II.
  4. Increased flow to distal nephron.

 

 

11

Regarding hypokalemia what can induce excessive flow to the distal nephron to induce excessive K wasting?

  1. Furosemide, thiazide diuretics. 
  2. salt-losing nephropathy. 
  3. Liddle-Syndrome. 

 

12

What are extra-renal causes of K loss (hypokalemia)?

  1. vomiting. 
  2. diarrhea/laxative abuse. 
  3. villous adenoma. 
  4. Zollinger-Ellison Syndrome. 

 

13

Hypernatremia with a urine osmolality>400mosm/kg is often caused by what two classes? 

  1. Non-renal cause
  2. Osmotic diuresis

 

14

What are non-renal causes of hyper-natremia that will have urine osmolality > 400mosm/kg?

  1. excessive sweating.
  2. loss via respiratory tract.
  3. osmotic diarrhea. 

 

 

15

What are the osmotic diuretic associated causes of hypernatremia with urine osmolality > 400 mosm/kg?

  1. Hyperglycemia
  2. Mannitol.

 

16

What are the categories of hypernatremia with urine osmolality < 250 mosm/kg?

  1. Central DI
  2. Nephrogenic DI. 

 

17

What is central DI?

Lack of production of ADH from the pituitary, to compensate for the fluid loss. excessive polyuria with dilute urine.  <250mosm/kg

 

18

What are causes of nephrogenic DI?

  1. Lithium/demeclocycline. 
  2. post-obstruction. 
  3. interstitial nephritis. 
  4. hypercalcemia/hypokalemia. 

 

19

What are common causes of hypomagnesemia? 

  1. Low intake
  2. Low absorption
  3. GI loss
  4. Renal loss
  5. Others. 

 

20

What are the common sources for decreased intake of Mg?

  1. Malnutrition
  2. Alcoholism
  3. total parenteral nutrition (TPN; feeding bypassing GI system)

 

21

What are common sources of reduced Mg absorption?

  1. Proton pump inhibitors. 
  2. Small bowel bypass. 
  3. Malabsorption.

 

22

What are the common routes of GI loss that lead to hypomagnesemia?

  1. Chronic diarrhea
  2. Laxative abuse. 

 

 

23

What are the common ways that renal loss can lead to hypomagnesemia?

  1. Diuretics
  2. Hyperaldosteronism
  3. Hyper-parathyroidism
  4. Hyper-thyroidism
  5. Hyper-calcemia
  6. Volume expansion
  7. Tubulo-interstitial disease. 
  8. Kidney transplant. 
  9. Drugs. 

 

 

24

What are "other" common sources of hypomagnesemia? 

  1. DM
  2. hungry bone syndrome
  3. respiratory alkalosis
  4. pregnancy. 

 

25

What are the main categorizations of Hypophosphatemia?

  1. low supply
  2. low absorption
  3. excessive loss
  4. intracellular shift. 
  5. electrolyte imbalance
  6. loss with low replacement

 

26

What are the causes of low supply hypophosphatemia?

  1. Starvation
  2. total parenteral nutrition (TPN)

 

27

What are the causes of low absorption hypophosphatemia?

  1. Malabsorption syndrome
  2. small bowel bypass
  3. oral antacids
  4. VitD deficiency

 

28

What are the causes of excessive loss hypophosphatemia?

  1. Phosphaturic drug
  2. Hyperparathyroidism
  3. Hyperthyroidism
  4. Renal tubular loss
    1. congenital
    2. fanconi syndrome
    3. multiple myeloma
    4. heavy metals
    5. alcholism

 

29

What are the causes of intracellular shift hypophosphatemia?

  1. IV glucose.
  2. Medications
  3. Hungry bone syndome
  4. respiratory alkalosis
  5. salicylate poisoning. 

 

 

30

What are the causes of electrolye related hypophosphatemia? 

  1. hypercalcemia
  2. hypomagnesemia
  3. metabolic alkalosis

 

31

What are the causes of hypophosphatemia due to excessive loss with poor replacement?

  1. re-feeding syndrome
  2. other....