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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
Someone with hypoNA and seizures , how do you treat the hypona?
aggressively . i..e 3 % Sodium Chloride
pts with hypoalbinemia will have what kind of Ca level?
Calcium homeostasis in blood is how?
- 1. Albumin bound Ca+ ( 45 % )
- 2. Ionized Ca+ (40%)
- 3. Ca+ cound to inorganic and organic anions (15%)
for every 1 gram decrease in albumin , serum CA decreases by how much?
Symptoms of HypoCa
Chvosteks sign, trousseaus sign, hyperpigmentation, seizures, muscular weakness,
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.
what is the leading cause of hypophosphatemia in hospitallized patients?
Continuous glucose infusion
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
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
Pt with Hyperosmolar hyperglycemic state (HHS) , management?
- 1. give fluids
- 2. than give insulin
DO NOT manage the hyperK+
manifestations of hyperK?
- 1. weakness
- 2. ECG abnormalities
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 )
treatment of alcoholic ketoacidosis?
UV DEX with Ns and thimaine ....insulin not really needed.
alcoholic ketoacidosis is characterized by:
- 1. anion gap acidosis,
- 2.increased osmolal gap,
- 3.ketonemia or ketonuria and
- 4. variable blood glucose levels.
Patients with HYPONA+ due to SIADH have ?
- 1. low plasma osmolality
- 2. increased urine osmolality
- 3. and a high urinary sodium concentration
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 )