Fluid And Electrolytes

Question 1

What is the normal range for sodium?

Answer 1

133-146mmol/L

Question 2

What are the symptoms of hypernatraemia?

Answer 2

Convulsions
Hypovolaemia
Thirst
Dehydration 
Oliguria
Postural hypotension
Tachycardia

Question 3

What drugs cause hypernatraemia?

Answer 3

Oral contraceptives 
Corticosteroids
Sodium bicarbonate
Sodium content in IV antibiotics
Lithium

Question 4

What do you use to treat hypernatraemia caused by volume depletion?

Answer 4

IV glucose

Question 5

What are the symptoms of hyponatraemia?

Answer 5

Drowsiness
Confusion 
Convulsions
Nausea
Vomiting

Question 6

What drugs cause hyponatraemia?

Answer 6

Antidepressants
Loop and thiazide diuretics
Carbamazepine
Desmopressin

Question 7

What is used to treat mild to moderate hyponatraemia?

Answer 7

Oral sodium chloride / sodium bicarbonate

Add glucose if water depletion

Question 8

What is used to treat severe hyponatraemia?

Answer 8

IV saline

Isotonic via peripheral vein
Concentrated via central vein

Give slowly as risk of osmotic demyelination syndrome

Question 9

What electrolytes are within ORT?

Answer 9

Potassium
Sodium
Glucose

Give over 3-4 hours in diarrhoea
Give over 12 hours in hypernatraemic dehydration

Question 10

How do you replace water deficit?

Answer 10

IV glucose

Question 11

What is metabolic acidosis?

Answer 11

Hyperchloraemia

Question 12

What is the normal level of Cl-?

Answer 12

103 mmol/L

Question 13

What is used to treat metabolic acidosis?

Answer 13

Sodium bicarbonate

If caused by low potassium - potassium bicarbonate

Question 14

What is the normal range for calcium?

Answer 14

2.1-2.58 mmol/L

Question 15

What do you use to treat hypercalcaemia?

Answer 15

Bisphosphonates

Corticosteroids

Question 16

What is used to treat hypercalcaemia of malignancy?

Answer 16

Calcitonin

Question 17

What is used to treat hypercalcaemia caused by hyperparathyroidism?

Answer 17

Cinacalcet

Paracalcitol in chronic renal failure

Question 18

What is used to treat hypercalciuria?

Answer 18

Bendroflumethiazide

Increase fluid intake and reduce dietary calcium

Question 19

What does hypocalcaemia cause?

Answer 19

Osteoporosis

Question 20

What is used to treat mild to moderate hypocalcaemia?

Answer 20

Vitamin D and calcium supplements

Question 21

What is used to treat severe acute hypocalcaemia?

Answer 21

Slow IV calcium gluconate

Too fast causes arrhythmias

Question 22

What is the normal range for magnesium?

Answer 22

0.7-1.05 mmol/L

Question 23

When is hypomagnesaemia common?

Answer 23

In alcoholics

Question 24

What can hypomagnesaemia lead to?

Answer 24

Hypo Ca2+, K+, Na+

Question 25

How do you treat hypomagnesaemia?

Answer 25

IV/IM magnesium sulphate

Question 26

What is the normal range of phosphate?

Answer 26

0.85-1.45 mmol/L

Question 27

What is used to treat hyperphosphataemia?

Answer 27

Calcium containing preparations as it is phosphate binding

Question 28

What is used to treat hypophosphataemia?

Answer 28

Phosphate Give IV if moderate-severe

Question 29

What is the normal range of potassium?

Answer 29

3.5-5.3 mmol/L

Question 30

What are the symptoms of hyperkalaemia?

Answer 30

Ventricular fibrillation | Cardiac arrest

Question 31

What are the drug causes of hyperkalaemia?

Answer 31

HADBEANS ``` Heparin ACEi/ARB Digoxin Beta blockers Eplerenone Amiloride NSAIDS Spironolactone ```

Question 32

How do you treat mild to moderate hyperkalaemia with no ECG changes?

Answer 32

Calcium resonium

Question 33

How do you treat acute, severe hyperkalaemia > 6.5 mmol/L?

Answer 33

Slow IV calcium gluconate IV insulin, glucose and salbutamol in addition Add sodium bicarbonate to correct compounding acidosis, but not through same line as causes precipitation

Question 34

What are the symptoms of hypokalaemia?

Answer 34

Muscle hypotonia | Arrhythmias

Question 35

What are the drugs that cause hypokalaemia?

Answer 35

Dare insult bettys tough carpet ``` Diuretics Insulin B2 agonist Theophylline Corticosteroid ```

Question 36

What is used to treat mild hypokalaemia?

Answer 36

Oral slow potassium chloride Smaller doses in renal impairment If caused by diuretics then a potassium sparing diuretic is preferred

Question 37

How do you treat severe hypokalaemia?

Answer 37

IV potassium chloride KCl injection overdose is fatal