Term
| What states have a metabolic acidosis with a high anion gap and a high osmolar gap? |
|
Definition
| acute methanol, ethanol, or ethylene glycol poisoing. |
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Term
| When are rectangular, envelope shaped crystals observed in the urine? |
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Definition
| These are consistent with calcium oxalate crystals, which are classically seen in pts with ethylene glycol poisoining. |
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Term
| 3 electrolyte abnormalities seen in chronic alcoholism: |
|
Definition
hypomagnesemia
hypokalemia
hypohposphatemia |
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|
Term
| Why does hypokalemia go along with hypomagnesemia? |
|
Definition
| Mg is an important cofactor for potassium uptake and maintenance of intracellular potassium levels. |
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Term
| First steps in the treatment of hypercalcemia: |
|
Definition
1. Fluids -- This increases renal excretion of calcium by decreasing calcium reabsorption in the proximal tubule.
2. Loop diuretics -- these inhibit calcium reabsorption in the loop of Henle. Giving furosemide before fluid resuscitation will worsen the dehydration as well as the hypercalcemia. |
|
|
Term
| persistent diarrhea causes: |
|
Definition
| A non-anion gap metabolic acidosis. (You poop out all your bicarb) |
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|
Term
| Agents used to shift potassium intracellularly: |
|
Definition
| insulin, glucose, sodium bicarbonate, beta 2 agonists like albuterol. |
|
|
Term
| What is metabolic acidosis resulting from acute kidney failure resulting from? |
|
Definition
| the kidneys' failure to excrete acids generated during normal protein metabolism, namely inorganic phosphates and sulfates. |
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|
Term
| What is contraction alkalosis? |
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Definition
| When a person is volume depleted, the RAAS system is activated, and H+ and K+ are dumped in order to retain sodium. This H+ dumping leads to a metabolic alkalosis. |
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Term
| Acid base disturbance that is normal in pregnancy: |
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Definition
| Chronic compensated respiratory alkalosis. Progesterone stimulates the medullary respiratory center. |
|
|
Term
| Acid base disturbance in an aldosterone deficiency: |
|
Definition
| normal anion gap hyperkalemic hyponatremic metabolic acidosis. Since there is no aldo to dump H+ and save sodium, there is a metabolic acidosis. |
|
|
Term
| What is the earliest symptom of hyperkalemia? |
|
Definition
|
|
Term
| What is sodium polystyrene sulfonate? |
|
Definition
| A K+ binding resin (kayexalate) |
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Term
| Increased serum calcium and increased/normal PTH. What is in your differential? |
|
Definition
1. Primary hyperparathyroidism
2. Familial hypocalciuric hypercalmemia
To differentiate between these look a the urinary calcium excretion. It will be nil/low in FHH, and high in primary hyperparathyroid. |
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|
Term
| Formula to correct calcium for low albumin: |
|
Definition
delta alb*0.8 + serum Ca = corrected Ca
normal alb = 4 |
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