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Name 3 ways diabetic ketoacidosis cause hyperkalemia?
- 1. A decrease of insulin, which normally pumps K+ from ECF into cells.
- 2. Polyuria due to osmotic effect of glucose in the urine leads to volume depletion & oliguria.
- 3. Oliguria decreases potassium excretion, which leads to hyperkalemia.
What are mechanisms of chronic alcoholism that cause predisposal to hypomagnesmia?
- 1. Poor dietary intake of Mg
- 2. Decreased Mg absorption from GI tract
- 3. Increased Mg excretion in urine due to (repeated) rising blood alcohol.
Chronic oliguria due to renal failure causes plasma excesses of which electrolytes?
- - Potassium
- - Magnesium
- *NOT calcium - vitamin D activation does not occur effectively, which leads to low plasma calcium.
What are the most common fluid/electrolyte imbalances seen wtih oliguric renal failure?
- - ECV excess
- - hyperkalemia
- - hypermagnesemia
- - hyperphosphalemia
- - hypocalcemia
Describe what happens with excessive ADH production.
- - Hyponatremia
- - Sometimes hypevolemia
- Why? ADH acts in the distal portion of the renal tubule and the collecting duct and causes the retention of water, but NOT solute. Hence, ADH activity effectively dilutes the blood (decreasing the concentrations of solutes such as sodium).
What are hallmarks of chronic inflammation?
With chronic inflammation, there is evidence of tissue repair & damage happening at the same time, so the inflammation persists (ie, cirrhosis).