10 Questions
What is the primary goal of administering 0.9% NS with KCL and Lasix in treating hypercalcemia?
To expand ECF and increase renal excretion of Ca+
Which of the following is NOT a treatment for hypercalcemia in patients with malignancy?
Estrogens
What is the recommended treatment for symptomatic and progressive hyperparathyroidism?
Surgery
What is the purpose of administering 99m Tc Sestamibi in hyperparathyroidism?
To map tumors prior to surgery
When referring a patient with hyperparathyroidism for surgery, what is an important consideration?
Sending the patient to a surgeon experienced in parathyroid exploration
What is the recommended daily dose of Prednisone for treating hypercalcemia?
20-40 mg/day PO
Which of the following is a treatment for mild hypercalcemia in postmenopausal women?
Estrogens
What is the purpose of administering NS and Lasix in treating hypercalcemia?
To expand ECF and increase renal excretion of Ca+
What is the primary goal of administering bisphosphonates in treating hypercalcemia?
To inhibit osteoclasts from absorbing bone
What is the recommended daily fluid output goal when treating hypercalcemia with NS and Lasix?
At least 3 liters/day
Study Notes
Advanced Laboratory Evaluation
- Topic: Disorders of Sodium, Calcium, Phosphorus, Magnesium, and Proteins, and Uncommon Anemias
Disorders of Sodium
- Hypernatremia: plasma Na+ >145 mEq/L, caused by a deficit of H2O relative to solute
- Mortality rate: 40-60%
- Hypernatremia implies hyperosmolality of ECF, which results in H2O moving out of intracellular spaces until cellular tonicity equals that of ECF
Risk Factors for Hypernatremia
- Vomiting
- Diarrhea
- Renal losses
- Extrarenal losses (e.g., burns, excess sweating)
- Hypertonic IV fluids
- Inability to access H2O
- Primary hypodipsia
- Reset osmostat
Effects of Hypernatremia on CNS
- Brain cellular H2O increases in acute and chronic hyponatremia
- Symptoms of CNS dysfunction are more common and greater in acute hyponatremia
Hyponatremia
- Principle causes: hypovolemia, euvolemia, and hypervolemia
- Hyponatremia with hypovolemia: GI losses, vomiting, and diarrhea
- Hyponatremia with euvolemia: SIADH, primary hyperparathyroidism
- Hyponatremia with hypervolemia: congestive heart failure, nephrotic syndrome
Disorders of Calcium
- Hypercalcemia: can be caused by primary hyperparathyroidism, humoral hypercalcemia of malignancy, and vitamin D excess
- Diagnostic tests: parathyroid hormone assays (e.g., IRMA)
- Further evaluation: rule out malignancy and impaired renal status, check urinary excretion of calcium
Treatment of Hypercalcemia
- Mild hypercalcemia in postmenopausal women: estrogens
- Vitamin D excess: prednisone 20-40 mg/day PO
- With normal renal function: IV 0.9% NS with KCL and Lasix to increase renal excretion of Ca+
- In patients with malignancy: bisphosphonates plus NS and Lasix
- If hyperparathyroidism is symptomatic and progressive: surgery is the treatment of choice
This quiz covers various electrolyte disorders, including sodium, calcium, and phosphorus disorders. Evaluate your knowledge of these lab-related topics.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
