electrolytes

Question 1

hypomagnesia

Answer 1

causes arrythmias icn risk of torsdade de pointes
neurological symptoms
more excitable nervous system as calcium

Question 2

what do we give in hyper magnesium

Answer 2

ca gluconate

Question 3

whats included in a bone profile l

Answer 3

ca
phosphate
ALP
albumin

Question 4

tx for hypocalcemia

Answer 4

aggressive fluid resuscitation and if refractory then biphosphanates

Question 5

why would yo order a bone profile test

Answer 5

if you suspect bony pathology

osteoporosis
osteomalacia
pagets disease
metastasis

Question 6

primary hyperparathyroid

Answer 6

Primary hyperparathyroidism is when there’s a problem within the parathyroid gland itself, usually a benign (non-cancerous) tumour of the gland.

So causes high levels of calcium in blood and pee
Reciprocal with phosphate

Question 7

secondary hyperpathyroidism(table)

Answer 7

Key word here is REACtIVe
Secondary hyperparathyroidism is when the glands are fine but a condition, like kidney failure, or low vit d lowers calcium levels and causes the body to react by producing extra parathyroid hormone.

Calcium levels can be normal or low

Question 8

tertiary hyperparathyroidism

Answer 8

ertiary hyperparathyroidism is when long-standing secondary hyperparathyroidism starts to behave like primary hyperparathyroidism. often associated with kidney failure

Question 9

whats an important complication of hypercalcemia

Answer 9

pancreatitis (qute rare and the mechanism is not well understaoon)

Question 10

symproms of hyper calcemia

Answer 10

stones : kidney damage
bones -pathological fractures
psychiatric moans- mood
groans - kidney stones, pancreatitis and constipation

Question 11

hypocalcemia signs and treatment

Answer 11

muscle weakness/cramps
tetany
perioral anesthesia

orally like calcichew
iv - calcium gluconate

Question 12

ALP marker is a sign of

Answer 12

cholestasis or bone disease or liver

Question 13

so how would you tell the difference between cholsetatis or bone disease in reference to ALP

Answer 13

do a GGT, if thats raise most likely liver

Question 14

An ALP rise with normal GGT suggests increased bone turnover
An ALP rise with associated GGT rise is more suggestive of cholestasis

Question 15

causes of isolated ALP (normal GGT)

Answer 15

healing bone fracturs
pagets disease
metasisis

Question 16

causes of Paget disease

Answer 16

osteoclasts are overactive

Question 17

what can casue hyperkalemia

Answer 17

1. medications like ace inhibitors and ARBS
2. taking too many k +sparing diuertics like spironotone
3. CKD
4. a lack of aldosterone(mineralcorticoid ) addisons
5. over supplementation

Question 18

with hyperkalemia what could the heart rate be

Answer 18

bradycardia

Question 19

what drugs can cause low sodium

Answer 19

dieretics
thiazides
carbamazepine is a well known cause
antidepressants- SSRIS(sertraline, escitalopram, fluoxetine) - cause the brain to release ADH esp in the first few months

Question 20

euvolaemic hyponatraemia

Answer 20

more dilutional in nature so actual sodium is normal but appears less

Question 21

what blood tests to order for low sodium

Answer 21

TSH - test for hypothryoidsim
CORTISOL - test for addiosns

Question 22

After how much non-responsive fluid resuscitation should a patient be considered fluid unresponsive?

Answer 22

2 L

Question 23

What is the expect pattern of serum and urine osmolalities is seen in SIADH?

Answer 23

urine osmolitiy will be high - very concentrated (think desert)

serum will be low

Question 24

How is hyponatraemia treated in the emergency setting?

Answer 24

IV 3% saline in a critical care setting

Question 25

What are the treatment options for SIADH?

Answer 25

Fluid restriction ADH receptor antagonists (e.g. tolvaptan, deomeclocycline) Oral sodium and furosemide

Question 26

signs of hyponatremia

Answer 26

vomiting headaches muscle weakness seizures coma arrythmias confusion