Advanced Lab: Electrolyte Disorders
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Advanced Lab: Electrolyte Disorders

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Questions and Answers

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+ (correct)
  • To induce estrogen release in postmenopausal women
  • To inhibit osteoclasts from absorbing bone
  • To control Vitamin D excess
  • Which of the following is NOT a treatment for hypercalcemia in patients with malignancy?

  • Prednisone
  • Bisphosphonates
  • Estrogens (correct)
  • NS and Lasix
  • What is the recommended treatment for symptomatic and progressive hyperparathyroidism?

  • Prednisone 20-40 mg/day PO
  • 99m Tc Sestamibi scan
  • Bisphosphonates and NS
  • Surgery (correct)
  • What is the purpose of administering 99m Tc Sestamibi in hyperparathyroidism?

    <p>To map tumors prior to surgery</p> Signup and view all the answers

    When referring a patient with hyperparathyroidism for surgery, what is an important consideration?

    <p>Sending the patient to a surgeon experienced in parathyroid exploration</p> Signup and view all the answers

    What is the recommended daily dose of Prednisone for treating hypercalcemia?

    <p>20-40 mg/day PO</p> Signup and view all the answers

    Which of the following is a treatment for mild hypercalcemia in postmenopausal women?

    <p>Estrogens</p> Signup and view all the answers

    What is the purpose of administering NS and Lasix in treating hypercalcemia?

    <p>To expand ECF and increase renal excretion of Ca+</p> Signup and view all the answers

    What is the primary goal of administering bisphosphonates in treating hypercalcemia?

    <p>To inhibit osteoclasts from absorbing bone</p> Signup and view all the answers

    What is the recommended daily fluid output goal when treating hypercalcemia with NS and Lasix?

    <p>At least 3 liters/day</p> Signup and view all the answers

    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

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    Description

    This quiz covers various electrolyte disorders, including sodium, calcium, and phosphorus disorders. Evaluate your knowledge of these lab-related topics.

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