ELECTROLYTES

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Author:
Anonymous
ID:
279558
Filename:
ELECTROLYTES
Updated:
2014-07-24 20:04:10
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Step
Folders:
medicine
Description:
Electrolytes
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  1. Man on loops and CHF and paralytic ileus , what do you next?
    Paralytic ileus is one the indication for prompt parenteral potassium replacement 

    Diuretic induced hypoK , and is common in CHF
  2. Someone with hypoNA and seizures , how do you treat the hypona?
    aggressively . i..e 3 % Sodium Chloride
  3. pts with hypoalbinemia will have what kind of Ca level?
    LOW.
  4. Calcium homeostasis in blood is how?
    • 1. Albumin bound Ca+ ( 45 % )
    • 2. Ionized Ca+ (40%)
    • 3. Ca+ cound to inorganic and organic anions (15%)
  5. for every 1 gram decrease in albumin , serum CA decreases by how much?
    .8
  6. Symptoms of HypoCa
    Chvosteks sign, trousseaus sign, hyperpigmentation, seizures, muscular weakness,
  7. Pt undegoes major abdominal surgery and post-op noted to have hyperactive deep tendon reflexes , which electrolyte is affected?
    • CA--> hypoca+
    • HypoCa+ can occur during or immediately after surgery , especially in pts undergoing major surgery and requiring transfusions.
  8. what is the leading cause of hypophosphatemia  in hospitallized patients?
    Continuous glucose infusion
  9. How does hypophosphatemia cause muscle weakness?
    • 1. Imparis ATP
    • 2. also a/w wirh 2,3 diphosphoglycerate --> causes a left shift of the oxyhemoglobin curve , so less o2 gets to tissue
  10. Euvolemic hypoosmolar hypona+ can be due to ? what do you do next?
    • 1. SIADH
    • 2. Hypothyroidism 
    • 3. Adrenal insufficiency

    - if hypona is mild --> correct underlying issues

    - Mode hypoNa+  + SIADH --> water restriction

    Sympotomatic HypoNa+--> hypertonic saline
  11. Pt with Hyperosmolar hyperglycemic state (HHS) , management?
    • 1. give fluids
    • 2. than give insulin

    DO NOT manage the hyperK+
  12. manifestations of hyperK?
    • 1. weakness
    • 2. ECG abnormalities
  13. ECG abnormality in Hyper K+? and how do you treat it ?
    • 1. peaked T waves
    • 2.  prolongated PR  and QRS
    • 3. disappearing p waves
    • 4. bradycardia
    • 5. treatment: B-agnostic or a combo of glucose and insulin to reduced K levels .. ( i,e calcium gluconate )
  14. treatment of alcoholic ketoacidosis?
    UV DEX with Ns and thimaine ....insulin not really needed.
  15. alcoholic ketoacidosis is characterized by:
    • 1. anion gap acidosis,
    • 2.increased osmolal gap,
    • 3.ketonemia or ketonuria and
    • 4. variable blood glucose levels.
  16. Patients with HYPONA+ due to SIADH have ?
    • 1. low plasma osmolality
    • 2. increased urine osmolality
    • 3. and a high urinary sodium concentration
  17. common causes of hepatic encephalopathy?
    • 1. GI bleeding
    • 2. HypoK
    • 3. HypoVol
    • 4. Hypoxia
    • 5. Sedatives or tranquilizers
    • 6. Metobolic alkolosis
    • 7. Infectious ( spontaneous bacterial peritonitis )

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