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PhosphateQuestions I
Quiz Phosphate Questions Chapter 17 Lewis p. 318
| Question | Answer |
|---|---|
| Phosphorus is a primary anion in the ICF or ECF? | ICF |
| Phosphorus is essential to the function of what? | 1. Muscle 2. RBC 3. Nervous System |
| Phosphorus is deposited with calcium for what structure? | Bone and tooth structure |
| What other involvement does phosphorus have? | 1. Acid base buffering system 2. Mitochondrial energy production (ATP) 3.Cellular uptake and use of glucose 4. Metabolism of CHO, proteins and fat |
| Maintenance of normal phosphate balance requires what? | Adequate renal functioning because the kidneys are the major route of phosphate excretion. A small amount is loss in feces |
| Phosphorus has a reciprocal relationship with which electrolyte? | Calcium. High phosphate serum level tend to cause low calcium serum level |
| What are the normal values for phosphate? | 2.4 mg/dL – 4.4 mg/dL |
| Name the two types of potassium imbalances and give the numerical value | 1. Hypophosphatemia is less than (<) 2.4 mg/dL 2. Hyperphosphatemia is greater than (>) 4.4 mg/dL |
| What is the MAJOR condition that can lead to hyperphosphatemia? | Acute or chronic renal failure that results in an altered ability of the kidneys to excrete phosphate |
| What are other causes that can lead to hyperphosphatemia? | 1. Chemotherapy for certain malignancies (lymphomas). 2. Excessive ingestion of milk or phosphate containing laxative 3. Large intake of Vitamin D that increase GI absorption of phosphates |
| Clinical manifestations of hyperphosphatemia primarily relate to what? | Metastatic calcium-phosphate precipitates |
| Ordinarily calcium and phosphate are deposited ONLY in: | Bone |
| When there is an increase serum phosphate along with calcium precipitates readily, what occurs? | Calcified deposits can occur in soft tissues such as joints, arteries, skin, kidneys and corneas |
| What are other manifestations of hyperphosphatemia? | Neuromuscular irritability and tetany, which are related to the low serum calcium levels often associated with high serum phosphate levels |
| Management of hyperphosphatemia is aimed at: | Identifying and treating the underlying cause |
| Give some examples of how to manage hyperphosphatemia: | 1. Ingestion of foods and fluids high in phosphorus (i.e. diary products) should be restricted. 2. Adequate hydration and correction of hypocalcemic conditions can enhance the renal excretion of phosphate through action of PTH |
| What happens to the level of phosphorous in the kidney as serum calcium level increases? | It causes renal excretion of phosphorus |
| What measures need to be taken with patients with renal failure? | Reduce serum phosphate levels including calcium supplements, phosphate binding agents or gels and dietary phosphate restriction. |
| Hypophosphatemia (low serum phosphate) is seen in patient who are: | 1. Malnourished or has a malabsorption syndrome 2. Alcohol withdrawals 3. Use of phosphate binding antacids 4. Parenteral nutrition with inadequate phosphorus replacement |
| Most clinical manifestations of hypophosphatemia relate to a deficieney of: | Cellular ATP or 2,3 diphosphoglycerate (2,3-DPG), an enzyme in RBC’s that facilitate oxygen delivery to the tissues |
| Because phosphorus is needed for formation of ATP and 2,3-DPG, its deficit results in: | Impaired cellular energy and oxygen delivery |
| True or False Mild to moderate hypophosphatemia is often asymptomatic. | True |
| Severe hypophosphatemia may be what? | Fatal because of decreased cellular function |
| Acute symptoms of hypophosphatemia include: | 1. CNS depression 2. Confusion 3. Other mental changes |
| Other manifestations of hypophosphatemia include: | 1. Muscle weakness and pain 2. Dysrhythmias 3. Cardiomyopathy |
| The management of MILD hypophosphatemia: | 1. Oral supplement (e.g. Neutra-Phos) 2. Ingestion of foods high in phosphours (e.g. dairy products) |
| The management of SEVERE hypophosphatemia: | IV administration of sodium phosphate or potassium phosphate. FREQUENT monitoring of serum phosphate levels is necessary to guide IV therapy |
| Sudden symptomatic hypocalcemia, secondary to increased calcium phosphorus binding is a: | Potential complication of IV phosphorus administration |
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Brainiacs
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