Electrolytes

Question 1

Digitalis

Answer 1

Shifts K out of cell (hyperkalemia)

Question 2

Hyperosmolarity

Answer 2

Shifts K out of cell (hyperkalemia)

Question 3

Insulin

Answer 3

Shifts K into cell (hypokalemia)

Question 4

Lysis of cells

Answer 4

Shifts K out of cell (hyperkalemia)

Question 5

Acidosis

Answer 5

Shifts K out of cell (hyperkalemia)

Question 6

Alkalosis

Answer 6

Shifts K into cell (hypokalemia)

Question 7

Beta-blockers

Answer 7

Shifts K out of cell (hyperkalemia)

Question 8

Low sodium

Answer 8

nausea, malaise, stupor, coma

Question 9

High sodium

Answer 9

irritability, stupor, coma

Question 10

Low potassium

Answer 10

U waves on ECG, flattened T waves, arrythmias, muscle weakness

Question 11

High potassium

Answer 11

Wide QRS waves and peaked T waves on EKG, arrhythmias and muscle weakness

Question 12

Low calcium

Answer 12

tetany, seizures, QT prolongation

Question 13

High calcium

Answer 13

Stones (renal), Bones (pain), Groans (ab pain), Pyschiatric Overtones (anxiety, altered mental status)

Question 14

Low Magnesium

Answer 14

Tetany, torsade de pointes

Question 15

High Magnesium

Answer 15

decreased DTRs, lethargy, bradycardia, hypotension, cardiac arrest, hypocalcemia

Question 16

Low phosphate

Answer 16

Bone loss, osteomalacia

Question 17

High phosphate

Answer 17

renal stones, metastatic calcifications, hypocalcemia

Question 18

Metabolic Acidosis

Answer 18

Decreased pH, pCO2, HCO3

Question 19

Metabolic Alkalosis

Answer 19

Increased pH, pCO2, HCO3

Question 20

Respiratory Acidosis

Answer 20

decreased pH, increased pCO2 & HCO3

Question 21

Respiratory Alkalosis

Answer 21

Increased pH, decreased pCO2 & HCO3

Question 22

Hyperventilation

Answer 22

Compensatory response to metabolic acidosis

Question 23

Formula for respiratory compensation for a simple metabolic acidosis

Answer 23

Winter’s Formula; if measured pCO2 differs significantly from predicted pCO2, mixed acid-base disorder is present

Question 24

Increased Anion Gap (Met Acidosis)

Answer 24

MUDPILES (>12mEq/L)
Methanol (formic acid), Uremia, DKA, Propylene glycol, Iron tablets or INH, Lactic acidosis, Ethylene glycol (oxalic acid), Salicylates (late)

Question 25

Normal Anion Gap (Met Acidosis)

Answer 25

Hyperalimentation, Addision Dx, Renal Tubular acidosis, Diarrhea, Acetazolamide, Spironolactone, Saline Infusion

Question 26

Causes of Respiratory Alkalosis

Answer 26

Hyperventilation (hysteria), hypoxemia, high altitudes, Early salicylates, tumor, pulmonary embolism

Question 27

Causes of Metabolic Alkalosis

Answer 27

Loops, Vomiting, Antacid, Hyperaldosteronism

Question 28

Causes of Respiratory Acidosis

Answer 28

Airway obstruction, acute & chronic lung disease, opioids, sedatives, weakening of respiratory muscles

Question 29

A disorder of renal tubules which leads to non-anion-gap hyperchloremic metabolic acidosis

Answer 29

Renal tubular acidosis

Question 30

Defect in alpha-intercalated cells to secrete H+; associated with hypokalemia; increase calcium phosphate kidney crystals

Answer 30

Type 1 Renal tubular acidosis | distal, pH >5.5

Question 31

Defect in proximal tubules HCO3- reabsorption, increased HCO3- excretion; urine is acidified by alpha-intercalated cells; assoc with hypokalemia

Answer 31

Type 2 Renal tubular acidosis | proximal, pH <5.5

Question 32

Hypoaldosteronism, aldosterone resistance or K-sparing diuretics; Hyperkalemia causing ammoniagenesis in PT

Answer 32

Type 4 Renal tubular acidosis | hyperkalemic, pH <5.5

Question 33

RTA with decreased buffering capacity so decrease H excretion into urine

Answer 33

Type 4 Renal tubular acidosis | hyperkalemic, pH <5.5

Question 34

RTA from Fanconi syndrome, Wilson, lead, aminoglycosides and carbonic anhydrase inhibitors

Answer 34

Type 2 Renal tubular acidosis | proximal, pH <5.5

Question 35

RTA from amphotericin B toxicity

Answer 35

Type 1 Renal tubular acidosis | distal, pH >5.5

Question 36

Multiple Myeloma (light chains)

Answer 36

Type 1 Renal tubular acidosis | distal, pH >5.5

Question 37

Chemical toxic to proximal tubule

Answer 37

lead and aminoglycosides