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20 Cards in this Set
- Front
- Back
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Hypovolaemic Hypernatraemia is caused by...
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Increased wate loss, propotional to Na. Causes are renal:
►diruetics ►glycosuria Or Extrarenal: ►sweating, vomiting or respiratory losses |
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Isovolaemic Hypernatraemia, is when Na remain normal and there is H2O loss, and is a result of.....
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►Diabetes insipidus
►Excess Skin Losses |
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Hyper volaemic Hypernatraemia is caused by
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increased Na proportional to H2O, caused by:
►Iatrogenic Na administration ►Saltwater/salt tablet ingestion ►Adrenal Hyperfunction (eg. Cushing's r Conn's-hyperaldosteronism) |
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Symptoms of Hypernatraemia:
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Hyperreflexia, Confusion
+ irritability, lethargy, stupor, coma. Muscle twitching, seizures. mental status changes |
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Symptoms of Hyponatraemia:
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Hyporeflexia + Nausea, vomiting
+Confusion, irritability, lethargy,, coma. Muscle twitches and seizures |
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Isovolemic hyponatremia is caused by...
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►water intoxication
►SIADH (syndrome of inappropriate antidiuretic hormone hypersecretion) ►hypothyroidism ►hypoadrenalism ►thiazide diuretics. |
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Hypovolemic hyponatremia is due to:
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Renal losses:
►diuretics, ►mineralocorticoid deficiency (Addison disease, hypoaldosteronism) Extrarenal Losses: ►sweating, vomiting, diarrhea ►third-spacing of fluids [burns, pancreatitis, peritonitis, bowel obstruction, muscle trauma] |
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Hypervolemic hyponatremia is seen with:
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►CHF,
►nephrosis, ►renal failure, ►liver disease, ►Excess Water Intake. Primary (psychogenic water drinking) or secondary (iatrogenic) |
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Hyperkalaemia is most due to:
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Inadequate Renal Excretion:
►Renal failure, ►volume depletion, ►medications that block K+ excretion (eg, spironolactone, triamterene), ►hypoaldosteronism, ►long-standing use of heparin, ►digitalis toxicity. Redistribution of K+: ►Tissue damage, ► acidosis, ►beta-blockers, ►decreased insulin, Excess Administration |
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Hyperkalaemia manifests as:
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►Weakness, flaccid paralysis, confusion
►Hyperreflexia, decreased motor strength ► ECG changes such as peaked T waves, wide QRS, loss of P wave, sine wave, asystole increased Chance of V Fib |
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ECG Changes in Hyperkalaemia:
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►peaked T waves, wide QRS, loss of P wave, sine wave, asystole
►increased Chance of V Fib |
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Hypokalaemia is caused by:
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Inadequate Intake (oral or IV)
GI Tract Loss (vomitnig or diarrhoea) Renal Loss: ►Diuretics and other medications, ►osmotic diuresis,( eg, hyperglycemia or ethanol), ►renal tubular disease , ►hypomagnesemia, ►ingestion of natural licorice, ►mineralocorticoid excess (hyperaldosteronism, Cushing syndrome, steroid use) Redistribution: ►Metabolic alkalosis, ►insulin administration, ►beta-adrenergic agents. |
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Hypokalaemia manifests as
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►orthostatic hypotension, .
►Muscle weakness, cramps, tetany ►Polyuria, polydipsia ►Decreased motor strength + ileus ECG changes, such as flattening of T waves, U wave becoming obvious (U wave is the upward deflection after the T wave.) |
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ECG changes seen in Hypokalaemia are:
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►flattening of T waves,
►U wave becoming obvious (U wave is the upward deflection after the T wave.) |
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Hypercalcaemia is caused by:
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Increased PTH
Malignancy Related (Tumour metastases and paraneoplastic syndromes) Vitamin D Related (Vit D intoxication, or sarcoidosis/other granulomatous disease) High Bone turnover ►Hyperthyroidism, ►Paget's disease, ►immobilization, Renal Failure: ►Secondary hyperparathyroidism Exogenous Intake |
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Symptoms of Hypercalcaemia:
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►Stones (renal),
►bones (osteitis fibrosa), ►moans (constipation), and ►groans (neuropsychiatric symptoms—confusion) Hyporeflexia + Shortening of the QT interval |
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ECG changes in Hypercalcaemia:
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Shortening of the QT interval
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Symptoms of Hypocalcaemia:
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►Hyperreflexia,
►facial nerve twitch + Trosseau’s sign ►Generalized seizures, tetany, ►Hypertension, peripheral and perioral paresthesia, abdominal pain and cramps, lethargy, irritability in infants Prolonged QT interval on ECG |
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Hypocalcaemia is caused by:
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►Critical Illness. (Sepsis can cause decreased Ca because of the decreased albumin that often occurs in critically ill patients.)
►PTH Deficiency. ►Vitamin D Deficiency. CRF, liver disease, use of phenytoin or phenobarbital, malnutrition, malabsorption. Other: ►Hyperphosphatemia, ►acute pancreatitis, ►osteoblastic metastasis, ►medullary carcinoma of thyroid. |
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ECG changes in Hypocalcaemia:
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Prolonged QT interval on ECG
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