Lytes Word Scramble
|
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Question | Answer |
hyponatremia = | Na <135 (symptoms seen at Na <125) |
Etiology of hypervolemic hypotonic hyponatremia | CHF, nephrotic syndrome, ARF, hepatic cirrhosis |
Etiology of euvolemic hypotonic hyponatremia | hypothyroid, glucocorticoid excess, SIADH, polydipsia, beer potomania |
Etiology of hypovolemic hypotonic hyponatremia | dehydration, diarrhea, vomiting |
Hyperkalemia (K >5) etiologies | ARF (most common), increased K load, metabolic acidosis, cell death, hyporeninemic hypoaldosteronism |
Hypokalemia (K <3.5) nonrenal (urine K <20) etiologies | GI losses (N/V/D, Z-E syndrome), metabolic alkalosis (increases K secretion) |
Hypercalcemia etiologies | HyperPTH (most common). Neoplasm (lung, head/neck, MM, NHL, cervical, RCC). Vit D intox. Paget. Adrenal insuff. Milk alkali syndrome. Sarcoid. ZE syndrome. Acromegaly. |
Dry skin, brittle nails, mx cramps, paresthesias, laryngospasm/stridor, hyper DTRs, SOB, crackles, S3, syncope & angina = | hypocalcemia (Ca <8.5); usu 2/2 CKD or hypoPTH |
Hyperphosphatemia (1.0-2.5); severe (<1.0) can lead to: | rhabdo, paresthesia, encephalopathy |
Hypermagnesemia (2.5 mEq/L) sx/sx | 1st: reduced DTRs; mx weak, hypoTN, resp depression, cardiac arrest; N/V, flushing; high bleeding time/coag |
Normal range: pH: | 7.40 (7.35-7.45) |
Normal range: pO2: | 80-100 mmHg |
Normal range: pCO2: | 35-45 mmHg |
Normal range: HCO3: | 22-26 mmol/L |
Anion gap = | cations (Na+) – anions (Cl- + HCO3-); Normal AG = 8-16 mmol/L |
Respiratory compensation for metabolic acidosis | pCO2 should fall 1.2 for every 1.0 drop in HCO3 |
Respiratory acidosis etiology | impairment in rate of alveolar ventilation; acute medullary resp ctr depression (narcotic OD), resp mx paralysis, airway obstruction; chronic (emphysema, pickwickian) |
Resp acidosis Sx/Sx | metab encephalopathy: somnolence, confusion, narcosis, asterixis. Fundi: dilated, tortuous vessels, possible papilledema |
Resp acidosis DDx/causes | COPD, airway obstruction, CNS depression (opioids, brainstem injury), neuromx (GBS, MG, botulism), myxedema |
Resp alkalosis (hypocapnia) Patho | hyperventilation reduces PCO2, increases pH |
Resp alkalosis Sx/Sx | lightheadedness, anxiety, perioral numbness, acroparesthesias (pain hands & feet) |
Resp alkalosis DDx | PE, pulmo edema, PTX, ARDS, pulmo art HTN, asthma, interstitial pulmo fibrosis |
NAGMA possible causes = | extrarenal bicarb loss (diarrhea, renal bicarb excretion); renal tubular acidosis; chronic renal failure, carbonic anhydrase inhibitors, diuretic, primary hyperPTHism, Addison dz |
AGMA: MUDPILES | methanol, uremia, DKA, propylene glycol, isoniazid, lactic acidosis [shock, septicemia, hypoxemia], ethylene glycol, salicylates |
AGMA: CUTE DIMPLES | C for Cyanide & T for Toluene plus MUDPILES |
Metab acidosis Sx/Sx | CP, palpitations, HA, AMS, decreased visual acuity, N/V/abd pain, wt loss, mx weakness, bone pain; Kussmaul (profound DKA), lethargy, stupor, coma, seizures; V-tach, hypotension |
Metabolic alkalosis: chloride-responsive (low urine Cl): due to: | diuretic tx (contraction alkalosis) or loss of gastric secretions (2/2 vomiting or NG tube) |
Metabolic alkalosis: chloride-resistant (high urine Cl): etiology | Bartter or Gittelman syndrome; hyperaldosteronism; bicarb intake in CKD |
Pathology of hypervolemic hypotonic hyponatremia | expansion of extracellular fluid relative to amount Na present |
Pathology of hypovolemic hypotonic hyponatremia | 1) extrarenal. 2) renal salt/volume loss based on urine Na level |
Conditions associated with isotonic hyponatremia | Hyperlipidemia (familial HLD or nephrotic syndrome), hyperproteinemia (multiple myeloma, macroglobulinemia) |
Isotonic hyponatremia patho | Na amount in plasma stays same, but more of other solutes -> decrease in relative Na conc |
Hypertonic hyponatremia etiology | Hyperglycemia (100mg/dL rise -> 1.5mEq/L Na drop); hypertonic tx (eg, mannitol) -> water leaves cells, Na leaves vascular space to extracellular space |
Hypernatremia defn = | serum Na >145mEq/L (osmo >290) |
Hypernatremia correction | Free water deficit = Wt x [(Na - 140)/140]. Correct over 48h; drop Na by 1mEq/L/hr. |
Hypokalemia (K <3.5) renal (urine K > 40) etiologies | diuretics, renal tubular acidosis, adrenal hormones, hyperaldosteronism, Cushing/steroids, digoxin, low Mg |
Hypokalemia clinical features | Muscle cramps, ileus, dysrhythmia |
Hypokalemia with acidosis & without HTN: suspect: | RTA |
Hypokalemia with high urine Cl without HTN / acidosis: suspect: | Diuretics or Bartter syndrome (low urine Cl = N/V) |
High dose K repletion for severe hypokalemia (<2.5 mEq/L) | Max 20 mEq/L/h and max 60 mEq/L. Should be via central venous access |
Dysrhythmias associated with severe hyperkalemia (>6.5) | Brady, prolonged PR, peaked T waves progressing to long QRS; V-fib |
Most potassium in body is found in: | Intracellular |
Hyperkalemia from K shift from intracellular to extracellular space may be 2/2: | Burns, rhabdo, hemolysis, severe infxn, internal bleeding, extreme exercise |
Hyperkalemia clinical findings | Initial hyperreflexia, then flaccid paralysis; vasodilation |
Hyperkalemia mgmt | IV beta-agonists (salbutamol), Na bicarb, IV insulin (w/D5NS); Ca gluconate (stabilizes cardiac membrane); SPS; loop diuretics; ?HD |
Ca distribution in body | 99% in bone. 0.01% in body fluids. 50% of Ca bound to albumin, 10% to other, 40% free. |
Hypocalcemia etiologies | CKD (most common: 2/2 decreased vit D production). Low albumin. Sepsis. Acute pancreatitis. Post-thyroid surgery. hypoPTH. Blood transfusion. Medullary ca of thyroid (calcitonin secretion). |
Hypocalcemia patho | Low Ca (2/2 low intake/absorption or low PTH or increased Ca into bone) -> lower NM excitation threshold -> reduced contractile force in vascular smooth & cardiac mm |
Symptomatic hypocalcemia mgmt. | IV Ca gluconate 10% infusion, ?IV CaCl |
Hypercalcemia clinical findings | Weakness, polydipsia, hyporeflexia, confusion, renal calculi, N/V, constipation, ileus, nephrogenic DI, bone pain/fx |
Hypercalcemia mgmt. | IVF forces urinary excretion of Ca. +/- furosemide (thiazide may worsen high Ca). +/-HD. |
Hypercalcemia mgmt.: underlying causes | Metastatic bone dz: calcitonin +/- pamidronate (inhibit bone resorption). Sarcoid/MM/leukeumia/BrCa/vit D intox: glucocorticoids |
PO4 distribution in body | 70% intracellular, 29% intraskeletal, <1% serum |
Hypophosphatemia etiology | Decreased GI absorption, vit D def, refeeding syndrome, hyper PTH, hyperthyroid, DKA, sepsis, ASA toxicity |
Severe hypophosphatemia results in: | Decreased affinity of Hgb for O2 |
Hypophosphatemia workup | Serum PO4 <2.5. Urine PO4 >20 = renal loss. PTH. Bone bx: ?osteomalacia. CK (rhabdo) |
Hyperphosphatemia etiology | CKD, AKI, hypoPTH, acromegaly. Increased intake, vit D, rhabdo, cell lysis, AGMA |
Phosphate binders | Sevelamer, lanthanum, Aluminum hydroxide |
Resp alkalosis (hypocapnia) etiology | Hyperventilation syndrome (?anxiety). GNR sepsis, cirrhosis, PE, CHF, ILD, PNA, pulmo edema, HAPE, CVA, anemia, PG (2/2 progesterone stim of resp ctr), acute ASA tox |
Low anion gap seen in: | NAGMA, myeloma, hypoalbuminemia, lithium Rx |
Created by:
Abarnard
Popular Medical sets