Electrolyte imbalances

Question 1

Symptoms of hypernatremia

Answer 1

Thirst
Olguria
Tachycardia
Postural hypotension
Convulsions
Dehydration

Question 2

Drugs that cause hypernatremia

Answer 2

Sodium bicarbonate
Sodium containing fluids
Corticosteroids
Oral contraceptives
Lithium

Question 3

Symptoms of hyponatremia

Answer 3

Confusion
Drowsiness
Nausea and vomiting
Headaches
Cramps

Question 4

Drugs that cause hyponatremia

Answer 4

Anticonvulsants e.g., sodium valproate, lamotrigine, carbamazepine
Antidepressants
Loop and thiazide-like diuretics
Desmopressin

Question 5

Treatment of mild to moderate hyponatremia?

Answer 5

Correct fluid imbalances
Sodium chloride or sodium bicarbonate
Add glucose if water depletion

Question 6

Treatment of severe hyponatremia?

Answer 6

IV sodium chloride

Question 7

Why is IV sodium chloride given slowly? q

Answer 7

To reduce the risk of osmotic demyelination syndrome

Question 8

Normal sodium range

Answer 8

133-146mmol/L

Question 9

Normal potassium range

Answer 9

3.5-5.3 mmol/L

Question 10

Symptoms of hyperkalaemia

Answer 10

cardiac arrest, ventricular fibrillation

Question 11

Drugs that cause hyperkalaemia

Answer 11

MRAs
Potassium sparing diuretics e.g., amiloride
Heparin
Digoxin
NSAIDs
BBs

Question 12

Mild to moderate hyperkalaemia treatment if no ECG changes?

Answer 12

Calcium resonsium

Question 13

Treatment of hyperkalaemia if severe (>6.5mmol/L)?

Answer 13

Calcium gluconate or chloride (to prevent myocardial excitability)
IV insulin and glucose to reduce serum levels
Salbutamol nebs or IV injection

Question 14

Hypokalaemia symptoms

Answer 14

Arrythmias
Muscle hypotonia

Question 15

Drugs that can cause hypokalaemia?

Answer 15

Loop diuretics
Beta 2 agonists
Theophylline
Corticosteroids
Insulin

Question 16

Treatment of mild hypokalaemia?

Answer 16

Slow potassium chloride e.g., Sando-K

Question 17

Side effect of potassium chloride (sando-K)

Answer 17

Vomiting/nausea

Question 18

Treatment for severe hypokalaemia?

Answer 18

IV potassium chloride

Question 19

Why must readily mixed bags of potassium chloride be used in hospitals?

Answer 19

KCL can be fatal if given overdose

Question 20

Normal range of calcium?

Answer 20

2.1-2.58mmol/L

Question 21

Treatment of hypercalcaemia?

Answer 21

Bisphosphonates or corticosteroids

Question 22

Treatment of hypercalcaemia associated with malignancy?

Answer 22

Calcitonin

Question 23

Treatment for mild hypocalcaemia?

Answer 23

Calcium and vit D supplements

Question 24

Treatment for severe hypocalcaemia?

Answer 24

IV calcium gluconate

Question 25

What must be done whilst infusing calcium gluconate?

Answer 25

ECG- increases risk of arrythmias

Question 26

Symptoms of hypercalcaemia?

Answer 26

Stomach upset Vomiting Constipation

Question 27

Symptoms of hypocalcaemia?

Answer 27

Tingling in the hands and feet Muscle spasms Brittle nails

Question 28

What is hypomagnesemia usually caused by?

Answer 28

Secondary to hypokalemia and hyponatremia

Question 29

Treatment for mild- to moderate hypomagnesemia?

Answer 29

Magnesium citrate, asparate, or glycerophosphate

Question 30

Treatment for severe hypomagnesemia?

Answer 30

IV magnesium sulphate

Question 31

Main causes of hypophosphatemia?

Answer 31

Alcohol dependence, TPN, severe diabetic ketoacidosis

Question 32

When should a phosphate binder be given in CKD?

Answer 32

CKD 3/4

Question 33

1st line phosphate binder for CKD?

Answer 33

Calcium acetate

Question 34

2nd line phosphate binder for CKD?

Answer 34

Sevelamer

Question 35

Electrolyte imbalances in hyperparathyroidism?

Answer 35

Hypercalcaemia, hypophosphateamia

Question 36

Treatment of hypercalcaemia associated with hyperparathyroidism?

Answer 36

Cinacalcet (Calcimimetic)