Electrolyte disturbance

Question 1

Normal serum K level

Answer 1

3.6-5.2mmol/L

Question 2

K content in slow K 600mg

Answer 2

8mmol

Question 3

K content in KCl syrup

Answer 3

1g = 13.5mmol

Question 4

K content in K citrate

Answer 4

1mL = 1 mmol

Question 5

Electrolyte content in Phosphate-sandoz tab

Answer 5

1 tab = 16mmol PO4 + 20mmol Na + 3mmol K

Question 6

Tx of hypoK & hyperK associaed with metabolic acidosis

Answer 6

Hypo K –> K citrate 15-30mL qid after meal

Hyper K –> NAHO3

Question 7

Onset of Ca gluconate / chloride 10% in hyperK

Answer 7

1-3mins

Question 8

Onset of NaHCO3 8.4% in hyperK

Answer 8

5-10mins

Question 9

Onset of DI drip in hyperK

Answer 9

30mins

Question 10

Onset of Resonium C / A in hyperK

Answer 10

1-2hrs

Question 11

Onset of salbutamol nebulizer in hyperK

Answer 11

15-30mins

Question 12

Duration of action of Ca gluconate / chloride 10% in hyperK

Answer 12

30-60mins

Question 13

Duration of action of NaHCO3 8.4% in hyperK

Answer 13

2hrs

Question 14

Duration of action of DI drip in hyperK

Answer 14

4-6hrs

Question 15

Duration of action of Resonium C / A

Answer 15

4-6hrs

Question 16

Duration of action of salbutamol

Answer 16

4-6hrs

Question 17

How effective is resonium C / A in lowering K

Answer 17

1g resonium bind 1mmol K

Question 18

CI of Ca gluconate / chloride 10% in hyperK

Answer 18

Digoxin toxicity –> dsrhthmia

Question 19

Indication & Dosing of fludrocortisone

Answer 19

For hyperK –> 0.1-0.2mg qD

Question 20

Normal serum Ca level

Answer 20

2.15-2.55mmol/L

Question 21

Agent used to tx malignant hyperCa

Answer 21

Pamidronate / Zoledronic aid

Question 22

Bisphosphonate 要隔幾耐先可以打下個dose

Answer 22

Separate for at least 7 days

Question 23

Elemental Ca in 10% CaCl2 & 10% Ca gluconate

Answer 23

10% CaCl2 –> 27mg/mL

10% Ca gluconate –> 9mg/mL

Question 24

Osmolarity of 10% CaCl2 & 10% Ca gluconate

Answer 24

10% CaCl2 –> 2000mOsm/L –> more irritation

10% Ca gluconate –> 680mOsm/L

Question 25

Normal serum Mg level

Answer 25

0.85 - 1.1mmol/L

Question 26

Agent used to correct HypoMg

Answer 26

50% MgSO4
Mylanta / Gelusil / Mg lactate
Amiloride PO

Question 27

Normal serum phosphate level

Answer 27

0.7-1.4mmol/L

Question 28

HypoNa + isovolaemia + Urine Na >20mmol/L

Answer 28

SIADH / Addison’s disease / Hypothyroid

Question 29

HypoNa + isovolaemia + Urine Na <10mmol/L

Answer 29

Water intoxiciation / Primary polydipsia / Beer potomania

Question 30

HypoNa + hypervolaemia + Urine Na >20mmol/L

Answer 30

Renal failure

Question 31

HypoNa + hypervolaemia + Urine Na <10mmol/L

Answer 31

CHF / cirrhosis

Question 32

HyperNa + hypervolaemia

Answer 32

Primary hyperaldosteronism / Cushing’s syndrome

Question 33

HyperNa + hypovolaemia

Answer 33

Diabetes insipidus / Osmoti diuresis

Question 34

Tx of SIADH

Answer 34

Water restriction
NaCl 900mg
Vasopressiin receptor antagonist (eg. Conivaptan / Tolvaptan)

Question 35

Tx of diabetes insipidus

Answer 35

Central DI –> DDAVP (eg. Desmopressin)

Nephrogenic –> X respond to DDAVP –> thiazide diuretics / amiloride

Question 36

NS VS Lactated Ringer’s VS Plasma-Lyte A

Answer 36

NS –> high Na (154mmol/L)
Lactated ringer’s –> low Na (130mmol/L)
Plasma-Lyte A –> pH 7.4 –> for acidosis