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CARDIOLOGY - RIA > Electrolytes > Flashcards

Electrolytes Flashcards

1
Q

role of Sodium?

A

aids in maintaining osmotic pressure of serum

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2
Q

symptoms of HYPONATRAEMIA

A
  • nausea
  • malaisa
  • confusion
  • headache
  • irritable
  • seizures
  • reduced consciousness
  • coma
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3
Q

hyponatraemia investigations

A
  • serum osmolality
  • urine osmolality
  • urinary sodium
  • TFTs
  • random cortisol
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4
Q

what does a high urinary sodium indicate?

A

sodium is being lost via the kidneys & water is following via osmosis

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5
Q

causes of high urinary sodium (4)

A
  • osmotic diuresis
  • excess use of loop diuretics
  • renal failure
  • addisons disease
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6
Q

causes of normal/low sodium & hypovolemia

A
  • D&V
  • fistulae
  • burns
  • trauma
  • CF
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7
Q

Euvolemic & high urinary sodium

A

SiADH

as sodium is being lost via kidneys

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8
Q

investigation findings in SiADH

A
  • high urine osmolality
  • low plasma osmolality

–> concentrated urine because more water is being reabsorbed from the DCT

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9
Q

pathophysiology behind SiADH

A

inappropriate amount of ADH produced by posterior pituitary gland

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10
Q

5 causes of SiADH

A
  • malignancy (small cell, pancreas, prostate, lymphoma)
  • stroke
  • head injury
  • TB
  • pnuemonia
  • hypothyroidism
  • lupus
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11
Q

drugs causing SiADH (6)

A
  • SSRIs
  • ACEi
  • anti psychotics e.g. carbmazepine
  • opiates
  • cytotoxics e.g. cyclophosphamide
  • PPIs
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12
Q

causes of Hypervolemic hyponatraemia? and mechanism?

A

fluid into extracellular space –> depletion of intravascular volume –> ADH release

ADH release causes water reabsorption via kidneys, diluting sodium levels

causes:
- nephrotic syndrome
- CCF
- liver cirrhosis
- renal failure

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13
Q

diuretic & example that lowers sodium level

A

Loop diuretic e.g. Bendroflumethiazide

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14
Q

life threatening complication of rapid correction of hyponatraemia?

& mechanism

A

Central pontine myelinolysis

Rapid increase in Na pulls water out of the cells causing destruction of the myelin sheath, especially in pons

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15
Q

symptoms of CPM

A
  • confusion
  • dysarthria
  • dysphagia
  • paralysis
  • coma
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16
Q

correction of hyponatraemia rate aim?

A

9 mmol/L/day

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17
Q

ECG changes in low Potassium

A
  • small/inverted T waves
  • prominent U waves
  • Prolonged PR interval
  • ST depression
18
Q

symptoms of low potassium

A
  • hypotonia
  • muscle weakness
  • tetany
  • cramps
  • palpitations
19
Q

GI symptoms of low potassium

A

constipation

20
Q

causes of low potassium

A
  • diuretics
  • D&V
  • poor oral intake
  • Cushings, conns, steroids
21
Q

drug causes of low potassium

A

salbutamol/insulin

22
Q

what is considered a severely low potassium level?

A

< 2.5

23
Q

3 group of drugs that can cause HYPERKALAEMIA

A

ACEi
NSAIDs
Potassium sparing diuretics

24
Q

causes of hyperkalaemia (4)

A
  • rhabdomyolysis
  • addisons disease
  • AKI
  • blood transfusion
25
Q

ECG findings for HYPERKALAEMIA

A
  • tall tented T waves

- broad QRS complex

26
Q

management of HYPERKALAEMIA (4)

A

A-E assessment & ECG

1) 10ml 10% calcium gluconate
2) Insulin infusion & dextrose
3) back to back salbutamol nebulisers
4) Calcium resonium

27
Q

treatment to stabilise cardiac membranes in hyperkalaemia

A

IV Calcium gluconate

28
Q

treatment to cause extracellular shift of potassium

A

combined insulin dextrose infusion

& nebulised salbutamol

29
Q

treatment to remove potassium from the body

A
  • dialysis
  • loop diuretics
  • calcium resonium
30
Q

ECG changes hypercalcaemia

A
  • shortened QT interval

…..more

31
Q

Management of hypocalcaemia

A
  • Rehydration of normal saline
  • Bisphosphonates
  • Calcitonin
  • Steroids (in sarcoidosis)
32
Q

Management of hypercalcaemia

A
  • Rehydration of normal saline
  • Bisphosphonates
  • Calcitonin
  • Steroids (in sarcoidosis)
  • radiotherapy
33
Q

role of PTH?

A

is secreted in response to low Calcium

causes:
- release of Calcium & phosphate from bones
- increased calcitriol production by kidney
- increased absorption of calcium from small intestine
- increased absorption of calcium from kidneys and decreased phosphate resorption

34
Q

change in Vit D production in response to calcium levels

A

low serum calcium –> vit D production upregulated

35
Q

role of Vit D?

A
  • increases Calcium absorption from small bowel
  • enhances bone turnover
  • increases resorption from kidneys
36
Q

role of calcitonin

A

released in response to high calcium. increases excretion of calcium & phosphate & reduces bone turnover

37
Q

symptoms of high calcium

A
  • abdominal pain/nausea/constipation
  • polyuria/polydipsia/renal stones
  • depression/confusion
  • tiredness/weakness
  • cardiac arrest
38
Q

ECG in high calcium

A

prolonged QT

39
Q

symptoms of los phosphate

A

Muscle weakness

40
Q

cause of low phosphate

A
  • vit d deficiency
  • alcohol withdrawal
  • refeeding syndrome
  • poor oral intake
  • renal tubular dysfunction
  • primary hyperparathyroidism
41
Q

cause of low magnesium

A
  • diuretics
  • diarrhoea
  • DKA
  • alcohol abuse

CARDIOLOGY - RIA (8 decks)

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