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Questions and Answers
A patient with chronic kidney disease is experiencing hypocalcemia. Which of the following mechanisms is most likely contributing to their low calcium levels?
A patient with chronic kidney disease is experiencing hypocalcemia. Which of the following mechanisms is most likely contributing to their low calcium levels?
- Alkalosis caused by the kidney disease, leading to increased calcium binding to albumin.
- Reduced activation of Vitamin D, leading to decreased calcium absorption. (correct)
- Excessive calcitonin secretion in response to bone demineralization.
- Increased parathyroid hormone secretion due to renal compensation.
A patient presents with muscle weakness, fatigue, and confusion. Lab results reveal hypercalcemia and a high level of parathyroid hormone (PTH). Which of the following is the most likely underlying cause of this patient's condition?
A patient presents with muscle weakness, fatigue, and confusion. Lab results reveal hypercalcemia and a high level of parathyroid hormone (PTH). Which of the following is the most likely underlying cause of this patient's condition?
- Vitamin D deficiency resulting in secondary hyperparathyroidism.
- Renal failure leading to decreased calcium excretion.
- Hypoparathyroidism leading to decreased bone resorption.
- Malignancy causing excessive secretion of parathyroid hormone-related protein (PTHrP). (correct)
A patient is admitted to the ICU with severe respiratory distress. Arterial blood gas (ABG) results show a pH of 7.20 and a PaCO2 of 65 mmHg. How will the patient's body attempt to compensate for this acid-base imbalance?
A patient is admitted to the ICU with severe respiratory distress. Arterial blood gas (ABG) results show a pH of 7.20 and a PaCO2 of 65 mmHg. How will the patient's body attempt to compensate for this acid-base imbalance?
- Increasing bicarbonate excretion by the kidneys.
- Decreasing hydrogen ion excretion and reabsorbing bicarbonate. (correct)
- Increasing the respiratory rate to eliminate excess carbon dioxide.
- Decreasing the respiratory rate to retain more carbon dioxide.
A patient with a history of chronic vomiting is brought to the emergency department. Arterial blood gas (ABG) analysis reveals a pH of 7.50 and an elevated bicarbonate (HCO3-) level. Which of the following compensatory mechanisms would the body most likely employ?
A patient with a history of chronic vomiting is brought to the emergency department. Arterial blood gas (ABG) analysis reveals a pH of 7.50 and an elevated bicarbonate (HCO3-) level. Which of the following compensatory mechanisms would the body most likely employ?
A patient experiencing diabetic ketoacidosis (DKA) presents with Kussmaul breathing. What is the primary purpose of this respiratory pattern in the context of metabolic acidosis?
A patient experiencing diabetic ketoacidosis (DKA) presents with Kussmaul breathing. What is the primary purpose of this respiratory pattern in the context of metabolic acidosis?
Flashcards
Hypocalcemia
Hypocalcemia
Low calcium levels in the blood, potentially causing seizures and cardiac issues.
Hypercalcemia
Hypercalcemia
Elevated calcium levels in the blood, possibly leading to encephalitis or a life-threatening crisis.
Respiratory Acidosis
Respiratory Acidosis
Inadequate ventilation leading to decreased pH and increased CO2.
Respiratory Alkalosis
Respiratory Alkalosis
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Metabolic Acidosis
Metabolic Acidosis
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Study Notes
- Ca2+ normal range is 9-11
Hypocalcemia
- Decreased parathyroid hormone can lead to injury or removal of the parathyroid
- Hypomagnesemia inhibits the action of parathyroid
- Alkalosis enhances Calcium binding to albumin
- Low vitamin D decreases the absorption of calcium
- Calcitonin prevents osteoclast function
- Pancreatitis causes calcium to be deposited in the abdomen
- Possible results include life threatening seizures and fatal cardiac dysrhythmias
Hypercalcemia
- Excessive parathyroid hormone may indicate malignancy or hyperparathyroid
- Acidosis decreases binding to albumin
- Hypervitaminosis D increases absorption of calcium
- Possible results include encephalitis in greater than 14% of patients and being life threatening in greater than 15% of patients and crisis.
Acid-Base
Respiratory Acidosis
- Inadequate alveolar ventilation results in decreased pH, increased carbon dioxide, and increased H+ in the blood
- Compensation: kidneys increase excretion of H+ and reabsorb HCO3, increased respiratory rate to remove carbon dioxide from the body
Respiratory Alkalosis
- Hyperventilation results in increased pH and decreased carbon dioxide, resulting in decreased H+ in the blood
- Compensation includes decreased respiratory rate. Kidneys decrease H+ excretion and increase absorption of HCO3
Metabolic Acidosis
- Renal and GI issues such as HCO3 loss, acid ingestion, and alterations in acid production, result in decreased pH and decreased HCO3, resulting in increased H+ in the blood
- Compensation includes hyperventilation, or Kussmaul breathing, characterized by rapid, deep breaths
Metabolic Alkalosis
- Renal and GI issues such as H+ loss, intracellular shift of H+, and retention of HCO3 result in increased pH and increased HCO3, resulting in decreased H+ in the blood.
- Compensation involves hypoventilation.
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Description
Overview of hypocalcemia and hypercalcemia, including causes such as parathyroid hormone levels, vitamin D, and acid-base balance. Covers respiratory acidosis, its causes like inadequate alveolar ventilation, and compensatory mechanisms involving kidney function.
