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Nephrology > TBL 1 > Flashcards

TBL 1 Flashcards

1
Q

Normal K level

A

3.5-5

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2
Q

Normal Mg level

A

1.7-2.3

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3
Q

Normal plasma osmolality

A

275-290

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4
Q

Normal Na level

A

135-145

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5
Q

Normal Ca level

A

8.5-10

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6
Q

Normal Phos level

A

2.5-4.5

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7
Q

how does hypokalemia affect the EKG

A

depressed T wave, hyperpolarization

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8
Q

symptoms of hypokalemia

A

weakness, cramping, fatigue, myalgias

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9
Q

how does hyperkalemia affect the heart

A

peaked T wave, hypopolarization

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10
Q

what cations are inside the cell

A

potassium and magnesium

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11
Q

what cations are outside the cell

A

sodium and calcium

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12
Q

what is the most abundant cation

A

potassium

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13
Q

where is the primary site of potassium excretion

A

distal tubule

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14
Q

what regulates potassium excretion

A

aldosterone, delivery of sodium and water to distal tubule

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15
Q

what regulates the internal balance of potassium

A

insulin, catecholamines, acid-base

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16
Q

what does alkalosis do to potassium

A

moves it into the cell

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17
Q

what does acidosis do to potassium

A

moves it out of the cell

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18
Q

insulin stimulates ____

A

potassium uptake

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19
Q

catecholamines activate ____

A

Na-K-ATPase pump

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20
Q

what drugs cause hypokalemia by increasing sodium and water delivery to distal tubules

A

diuretics, aminoglycosides, penicillins

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21
Q

what drugs cause hyperkalemia

A

K-sparing diuretics, ACEi/ARB, NSAIDs, heparin, cyclo, tacro, trimethoprim, pentamidine

22
Q

how can you treat hyperkalemia

A

calcium gluconate/chloride, insulin, albuterol, sodium bicarb, loop diuretics, potassium binders

23
Q

what is the main site of magnesium reaborption

A

loop of henle

24
Q

what are some drugs that cause hypomagnesemia

A

diuretics (loop bc Mg loop of henle), alcohol, aminoglycosides, ampho b, cisplatin, cyclo, tacro

25
Q

what are some non-drug causes of hypomagnesemia

A

alcoholism, short gut syndrome, pancreatic insufficiency

26
Q

what are some symptoms of hypomagnesemia

A

depressed T wave/prominent U wave (hypokalemia), positive chvostek/trousseua sign (hypocalcemia), tetany, convulsions, muscle cramps, neuromuscular irritability, tremor

27
Q

how can you treat asymptomatic hypomagnesemia >1.0

A

oral supplementation, look out for diarrhea

28
Q

how can you treat symptomatic hypomagnesemia <1.0

A

IV magnesium 2-4 g IV over 2-4 hours (causes vasodilation if given too fast)

29
Q

what are some causes of hypermagnesemia

A

antacids, cathartics, renal failure

30
Q

how can you treat hypermagnesemia

A

calcium chloride/gluconate, forced diuresis (saline w/ furosemide IV)

31
Q

parathyroid hormone increases calcium _____

A

reabsorption

32
Q

parathyroid hormone increases phosphate ____

A

excretion

33
Q

parathyroid hormone activates ____

A

vitamin D

34
Q

calcium _____ calcium reabsorption

A

decreases

35
Q

_____ diuretics cause hypercalcemia

A

thiazide

36
Q

when to administer phosphate binders

A

with meals

37
Q

hypercalcemia effect on the heart

A

decreased QT interval, broadened T waves, first degree AV block

38
Q

hypocalcemia effect on the heart

A

increased QT interval, AMI, CHF

39
Q

symptoms of severe hypophosphatemia

A

decreased energy stores (ATP), decreased RBC 2,3-DPG concentration (decreases release of oxygen to peripheral tissues, may result in tissue hypoxia)

40
Q

symptoms of acute hyperphosphatemia

A

deposition of Ca-Phos crystals, hypocalcemia

41
Q

chronic symptoms of hyperphosphatemia

A

hypocalcemia, soft tissue calcification, secondary hyperparathyroidism, bone disease

42
Q

neuromuscular symptoms of hypocalcemia

A

tetany, chvostek and trousseu signs, paresthesias, muscle cramps

43
Q

dermatologic symptoms of hypocalcemia

A

hair loss, grooved, brittle nails, eczema

44
Q

____ diuretics cause hyponatremia

A

thiazide

45
Q

hyponatremia causes the brain to ____

A

swell

46
Q

hypernatremia causes the brain to _____

A

shrink

47
Q

what happens when you over-correct hyponatremia

A

osmotic demyelination

48
Q

isovolemic hyponatremia can be caused by syndrome of inappropriate ___

A

ADH

49
Q

isovolemic hyponatremia can be caused by _____

A

diabetes insipidus (central or nephrogenic)

50
Q

central DI is caused by _____

A

decreased ADH secretion

Nephrology (3 decks)

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