Hyper/hypophosphatemia

Question 1

Normal range for phosphate?

Answer 1

Normal Range: 1.9 - 4.3 mg/dL

Question 2

Importance of phosphate?

Answer 2

muscle contraction

Question 3

When do you experience symptoms of phosphate deficiency?

Answer 3

develop when phosphate is below 0.6mmol/L, non specific

Question 4

Differentials of low phosphate?

Answer 4

Hypokalemia, Hypothyroidism, Hypomagnesemia, Primary muscle disorder

Question 5

What other electrolytes do you test for in phosphate deficiency?

Answer 5

1. calcium
2. magnesium
3. potassium

Question 6

Calcium and phosphate deficiency?

Answer 6

1. High calcium levels with low phosphate levels suggest primary hyperparathyroidism
2. low calcium levels suggests vitamin D deficiency or malabsorption

Question 7

Magnesium and phosphate deficiency?

Answer 7

Low magnesium levels are also suggestive of poor nutrition

Question 8

Potassium and phosphate deficiency?

Answer 8

Serum potassium derangements, especially hypokalemia, may occur with such as diabetic ketoacidosis and alcoholism

Question 9

Causes of hypophosphotaemia?

Answer 9

1. internal redistribution
2. decreased intestinal redistribution
3. increased urinary excretion

Question 10

Causes of Internal redistribution in hypo?

Answer 10

1. hyperinsulinaemia
2. Acute respiratory alkalosis
   Trauma, burns, sepsis
   symptoms - tetany

Question 11

Causes Decreased intestinal redistribution in hypo?

Answer 11

1. inadequate intake - alcoholism
2. antacids containing aluminium or magnesium
3. steatorrhea
4. chronic diarrhea
   symptoms
5. respiratory failure
6. hypotension, cardiac arrythmias, heart failure
7. altered mental status seizures
8. rhabdomyolysis

Question 12

Causes of increased urinary excretion in hypo?

Answer 12

1. Vitamin D deficiency
2. Drugs e.g. diuretics,
3. Primary Hyperparathyroidism
4. Genetic/acquired syndromes of phosphate wasting

Question 13

Symptoms of hypophophatemia?

Answer 13

1. tetany
2. weakness
3. respiratory failure
4. hypertension
5. cardiac arrythmias
6. heart failure
7. altered mental status seizures
8. rhabdomyolysis