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Y4 SA - Urogenital > Electrolytes & minerals > Flashcards

Electrolytes & minerals Flashcards

1
Q

Which electrolytes/minerals are extracellular?

A

Sodium
Chloride
Bicarbonate

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2
Q

Which electrolytes/minerals are intracellular?

A

Potassium
Phosphate
Proteins
Magnesium
Sulphate

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3
Q

Name the major cation in the ECF

A

Sodium

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4
Q

What is the function of sodium?

A

Maintains water in the body

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5
Q

How are sodium and water regulated in the body?

A

RAAS - controls circulating volume
ADH - controls osmolarity

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6
Q

Describe the RAAS

A
  • Renin converts angiotensinogen into angiotensin I
  • Conversion of angiotensin 1 to angiotensin 2 is done by angiotensin converting enzyme (ACE)
  • Angiotensin 2 acts on the adrenal gland to release aldosterone
  • Angiotensin 2 also causes vasoconstriction -> increased BP
  • Increased BP + aldosterone -> Na retention and water retention with K loss
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7
Q

Describe the function of ADH

A
  • ADH is released from the pituitary gland in response to an increase in blood osmotic pressure
  • ADH causes increased permeability of the collecting duct
  • Water is reabsorbed to prevent further dehydration
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8
Q

Loss of sodium and water is due to?

A

Volume depletion

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9
Q

What are the causes of hyponatraemia?

A
  • Losing sodium: GI loss, kidney loss, Addisons, Drugs (Furosemide)
  • Gaining water: CHF, iatrogenic
  • Other: Increased plasma osmolarity e.g. severe hyperglycaemia
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10
Q

What are the causes of hypernatremia?

A
  1. Hypotonic fluid loss - lose water and abit of sodium: GI loss, kidney loss
  2. Free water loss - losing water: heat stroke, pyrexia, diabetes insipidus, no access to water, adipsia
  3. Gain salt - excessive intake
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11
Q

Potassium concentration in plasma is controlled by?

A

Aldosterone

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12
Q

Describe filtration of potassium

A

Freely filtered at the renal glomerulus then resorbed

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13
Q

How are hypo and hyperkalaemia defined by plasma K concentrations?

A

Hypo = K < 3mmol/l
Hyper = K > 7.5mmol/l

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14
Q

List the clinical signs of hypokalaemia

A

Muscle weakness
PU/PD
Anorexia
Ileus / constipation

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15
Q

What are the causes of hypokalaemia

A
  • Decreased intake: anorexia, fluid therapy with a low K fluid
  • Translocation from ECF to ICF: insulin, catecholamines
  • Loss: GI, renal, drugs
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16
Q

What are the clinical signs of hyperkalaemia?

A

Muscle weakness
Cardiac abnormalities
- Bradycardia

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17
Q

Describe the ECG of a pateint with hyperkalaemia

A

Lost P wave as the AV node cant work, spikey tall T waves
Atrial standstill
Life threatening conduction abnormalities
Fast rhythms are also possible

18
Q

What are the causes of hyperkalaemia?

A
  • Artefactual
  • Decreased urinary excretion: urethral obstruction, bladder rupture, addisons, drugs
  • Translocation from ICF to ECF: insulin deficiency, tumour lysis syndrome
  • Increased intake: iatrogenic, excess supplementation
19
Q

Name 2 drugs that could cause hyperkalaemia

A

ACE inhibitors
K sparing diuretics

20
Q

How is hyperkalaemia treated?

A
  • IVFT: 0.9% NaCl, or Hartmann’s
  • Insulin: can help drive potassium into cells
  • Calcium gluconate
  • Treat primary cause e.g. Addison’s, DKA, AKI, FLUTD, etc
21
Q

Name a hormone that affects potassium levels

A

Insulin

22
Q

Name a hormone that affects sodium levels

A

ADH

23
Q

What is the most important hormone for controlling plasma osmolarity?

A

ADH

24
Q

Failure of which organ is commonly associated with hyponatraemia?

A

Heart

25
Q

What % of calcium is ioinised?

A

50%

26
Q

What % of calcium is protein bound?

A

40%

27
Q

What is the main clinical sign of hypercalcaemia?

A

PUPD

28
Q

What are the most common causes of hypercalcaemia?

A
  1. Malignancy
    - LYMPHOPROLIFERATIVE DISEASES = By far the most common cause
    - Anal sac adenocarcinoma
    - Many others
  2. Renal failure
  3. Primary hyperparathyroidism
29
Q

List some less common causes of hypocalcaemia

A

Addison’s disease
Vitamin D toxicity E.g. Cholecalciferol rodenticide toxicity
Bone lesions e.g. OSA
Artefact: Lipaemia, haemolysis

30
Q

List the clinical signs of hypocalcaemia

A

Muscle tremors, twitches, cramps
Seizures
Restlessness, behavioural changes

31
Q

What needs to be ruled out as the cause of hypocalcaemia?

A

Hypoalbuminaemia
Error: EDTA or citrate tube

32
Q

List the causes of hypocalcaemia

A
  1. Eclampsia
    - From the day before whelping to about 2 days after
    - Emergence
  2. Renal disease
  3. Hypoparathyroidism
  4. Post thyroidectomy in cats
  5. Nutritional - all meat diet
  6. Ethylene glycol toxicity
  7. Acute pancreatitis
33
Q

Phosphate homeostasis is regulated by …?

A

Parathyroid hormone (PTH)

34
Q

What is the overall effect of PTH?

A

Retain calcium and increase phosphorus excretion…i.e. to reduce plasma [PO4]

35
Q

List the causes of hyperphosphataemia

A
  1. Failure to excrete
    - Decreased GFR e.g kidney disease
    - UT obstruction/rupture
  2. Increased release from bone - Young animals
  3. Increased intake
    - Hypervitaminosis D
    - High phosphate diet
  4. Hypoparathyroidism
  5. Tumour lysis syndrome
  6. Spurious: Haemolysis: tends to be mild
36
Q

List the causes of hypophosphataemia

A

Rarely a clinical concern but can be sometimes:
- Anorexia (cat)
- Insulin use in DKA
- Primary hyperparathyroidism
- Hepatic lipidosis in cats

37
Q

In hypoparathyroidism, what happens to serum phosphate?

A

Increases

38
Q

You get some EDTA in your serum sample by mistake. What is the effect?

A

High K, low Ca

39
Q

A dog is overdosed on benazepril. What is the effect on serum electrolytes?

A

High potassium as RAAS is inhibited

40
Q

A dog presents with tremors, focal seizures, and pawing at the face. What electrolyte change is present?

A

Hypocalacemia

Y4 SA - Urogenital (12 decks)

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