Electrolytes Tutoring (Part 2): calcium, Phosphate, Potassium, and Magnesium By Alaina darby

JR shows up to the ER with renal dysfunction and a calcium concentration of 7 mg/dl. His albumin is 1.5 g/dl. How would you evaluate his calcium concentration? High Normal Low

FK shows up to the ER with renal dysfunction and a calcium concentration of 6.5 mg/dl. His albumin is 2 g/dl. How would you evaluate his calcium concentration? High, corrected to 11 Normal, corrected to 9 Normal, corrected to 8 Low, corrected to 8 Low, it does not need to be corrected

FK shows up to the ER with renal dysfunction and a calcium concentration of 6.5 mg/dl. His albumin is 2 g/dl. What is the likely cause of his low calcium level? Loss of conversion of 25-OH D to 1,25(OH)D Decreased release of PTH from the parathyroid Increased uptake of calcium by bone Decreased hepatic production of 25-OH D

JR has low calcium and low magnesium JR has low calcium and low magnesium. What is the likely cause of his low calcium level? Loss of conversion of 25-OH D to 1,25(OH)D Decreased release of PTH from the parathyroid Increased uptake of calcium by bone Decreased hepatic production of 25-OH D

Which of the following medications does not cause hypocalcemia through renal wasting mechanisms? Loop diuretic Amphotericin B Cisplatin Bisphosphonates

Which of the following patients should be treated for hypocalcemia? Patient with renal failure and iCa of 1.2 Patient who overdosed on diltiazem with unknown iCa or Ca Patient who had a blood transfusion with Ca of 7 Patient undergoing hemodialysis with Ca of 6

For the Patient who overdosed on diltiazem… iCa came back as 0. 8 For the Patient who overdosed on diltiazem… iCa came back as 0.8. How would you treat him? 2g IVPB over 2 hours 4g IVPB over 2 hours 2g IVPB over 4 hours 4g IVPB over 4 hours

The nurse administered 4 g over 2 hours The nurse administered 4 g over 2 hours. Which of the following may occur? Tachycardia Hepatitis Cerebral artery vasospasm None of these will likely occur

An anorexic patient comes into the ER in a coma An anorexic patient comes into the ER in a coma. Which of the following should be started with her TPN? Calcium Phosphate Magnesium Potassium

A patient with a TBI has a phos of 1. 8. His body weight is 75 kg A patient with a TBI has a phos of 1.8. His body weight is 75 kg. Which of the following should you give? 48 mmol at 5 mmol/hr 48 mmol at 7.5 mmol/hr 25 mmol at 5 mmol/hr 24 mmol at 7.5 mmol/hr

Your patient has renal impairment which has caused hyperphosphatemia Your patient has renal impairment which has caused hyperphosphatemia. His labs: ca 10.5, mag 1.3, K 4.5. Which should you give him? Selevamer Calcium acetate Aluminum hydroxide No treatment should be given

Which of the following does not cause hypokalemia? HCTZ Furosemide Amoxcillin Lisinopril

VD is anorexic and has a potassium concentration of 2. 7 VD is anorexic and has a potassium concentration of 2.7. What is the most likely estimate of her current body stores? 10 mEq/kg 15 mEq/kg 20 mEq/kg 25 mEq/kg

VD is anorexic and has a potassium concentration of 2. 7 VD is anorexic and has a potassium concentration of 2.7. How should potassium be administered if she has a J tube and not on an ECG monitor? KCl 40 mmol/L to enteral feeding KCl 60 mEq/L at a rate of 10 mEq/hr KCl 40 mEq/L at a rate of 20 mEq/hr KCl 40 mEq bolus

VD is anorexic and has a potassium concentration of 2. 7 VD is anorexic and has a potassium concentration of 2.7. Her creatinine is rising. What dose of potassium should she get? 20 mEq x 2 20 mEq x 3 40 mEq x 2 40 mEq x 3

Which of the following drugs itself does not cause hyperkalemia? Heparin Trimethoprim Penicillin G Octreotide

Furosemide Foscarnet Amphotericin B Cisplatin FK has was given a regimen of furosemide, foscarnet, amphotericin B, and cisplatin when he was hospitalized 6 months ago. Which of the following likely has caused his current hypomagnesemia? Furosemide Foscarnet Amphotericin B Cisplatin

DG has a serum magnesium concentration of 1. 3. his weight is 75 kg DG has a serum magnesium concentration of 1.3. his weight is 75 kg. What is likely his deficit? 50 mEq 100 mEq 150 mEq 200 mEq

DG has a serum magnesium concentration of 1. 3. his weight is 75 kg DG has a serum magnesium concentration of 1.3. his weight is 75 kg. How should he be treated? 40 g/hr IV 80 g/hr IV Mag oxide 1-2 tabs PO BID Mag gluconate 1-2 tabs PO BID

DG has a serum magnesium concentration of 1. 3. his weight is 75 kg DG has a serum magnesium concentration of 1.3. his weight is 75 kg. You treated him with Mag oxide 1-2 tabs PO BID. When should you expect to see his magnesium normalize? 24 hours 48 hours 5 days 10 days

JD is a 54 y/o WM. His labs are the following: Na 130 Ca 5.6, iCa 1.1 Mg 1.5 Phos 3.6 K 3.0

JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5. 6, iCa 1 JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5.6, iCa 1.1, Mag 1.5, Phos 3.6, K 3.0 How should you treat his hypocalcemia? Magnesium and calcium Calcium only Magnesium only Calcium and vitamin D

JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5. 6, iCa 1 JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5.6, iCa 1.1, Mag 1.5, Phos 3.6, K 3.0 Which of the following might be caused by his Mag level? Hyponatremia Hypokalemia Hypophosphatemia Hypomagnesemia

JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5. 6, iCa 1 JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5.6, iCa 1.1, Mag 1.5, Phos 3.6, K 3.0 He is experiencing muscle weakness, what is likely to have caused this? Hyponatremia Hypokalemia Hypophosphatemia Hypocalcemia

JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5. 6, iCa 1 JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5.6, iCa 1.1, Mag 1.5, Phos 3.6, K 3.0 Why shouldn’t he be given insulin even if he has hyperglycemia? Hyponatremia Hypokalemia Hypophosphatemia Hypocalcemia

JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5. 6, iCa 1 JD is a 54 y/o WM. His labs are the following: Na 130, Ca 5.6, iCa 1.1, Mag 1.5, Phos 3.6, K 3.0 Which can be caused by hyperparathyroidism? Hyponatremia Hypokalemia Hypophosphatemia Hypocalcemia