Electrolytes

Hypo meaning

Hyper meaning

Hypo - too low

Hyper - too much

What is potassium used for (K⁺)

Heart and skeletal muscles.

EKG changes:

Arrhythmias (irregular heart rhythm)

weakness

What are the danger zones, caution zones and safe zones for Potassium (K⁺)

What is Hypokalemia? Signs/symptoms selected causes

Hypokalemia (not enough potassium)

Signs/symptoms: Arrhythmias. Muscle weakness → paralysis (lower extremities) U waves and flattened T waves {EKG}

Causes: Increased renal loss (diuretics). Increased Gi losses (vomiting/diarrhea)

Increased K entry into cells. Hypomagnesemia. Cannot correct K until Mg is corrected.

What is Hyperkalemia? Signs and symptoms and causes.

Hyperkalemia: too much potassium in the body

Signs/symptoms: Heart palpitations, muscle weakness EKG changes. Nausea vomiting.

Causes: Decreased K excretion in urine (acute and chronic kidney disease.) Insulin deficiency. Beta blockers. Lysis of cells.

Beta blockers

1. any of a class of drugs which prevent the stimulation of the adrenergic receptors responsible for increased cardiac action, used to control heart rhythm, treat angina, and reduce high blood pressure.

What are the calcium level ranges? (Ca²⁺)

9-10 normal

10-10.5 need investigation

10.5-12 danger usually require surgery

Hypocalcemia: <8.5 mg/dL

Hypercalcemia > 10.5 mg/dL

What is Hypercalcemia? Symptoms and causes

Hypercalcemia: Too high levels of calcium

Symptoms: Often asymptomatic. Kidney stones. Excessive free water excretion. Loss of ability to concentrate urine. Decreased GFR → acute renal failure.

Causes: Hyperparathyroidism (parathyroid glands create high amounts of parathyroid hormone in the bloodstream.) Malignancy (cancerous cells)

Kidney stones, renal failure, Bone pain. Anxiety, altered mental state.

Hypervitaminoses D. Calcitriol supplements.

What is Hypocalcemia. Symptoms and causes

Hypocalcemia: too little calcium in the body

Symptoms: Tetany (a condition marked by intermittent muscular spasms, caused by malfunction of the parathyroid glands and a consequent deficiency of calcium.) Muscle twitches, Calcium blocks Na channels in neurons

Low Ca ➜easy depolarization ➜spontaneous contractions

•High Ca ➜difficult depolarization➜weakness

•Hyper-excitability of neurons and motorend plates

•Trousseau's sign: Hand spasm with BP cuff inflation

•Chvostek's sign: Facial contraction with tapping on nerve

•Seizures

What is Hypermagnesemia? (Mg²⁺) levels and Hypomagnesemia levels?

Hypermagnesemia: <1.7mg/dL

Hypomagnesemia: >2.4 mg/dL

Hypermagnesemia symptoms and causes.

Signs: Mg blocks Ca and K channels. Neuromuscular toxicity (decreased reflexes and paralysis). Bradycardia (slow HR) hypotension (low BP) cardiac arrest. Hypocalcemia (inhibit PTH secretion) Hypermagnesemia

Causes: Renal failure (kidney failure). Excessive intake of lots of Mg than the kidneys are able to excrete.

Hypomagnesemia symptoms and causes. (not enough Mg²⁺)

Symptoms: Tetany/tremor (neuromuscular excitability). Hypocalcemia. Hypokalemia (not enough Calcium and Potassium).

Causes: Pancreatitis (inflammation of the pancreases) Renal loss. Alcohol abuse. Drugs.

Hypomagnesemia/Parathyroid Gland

Low Mg

•↑ PTH release (same effect as calcium)

•↑ GI and renal magensium along with calcium

Very low Mg ➜inhibits PTH release

•Some Mg required for normal CaSR function

•Abnormal function ➜suppression of PTH release

•Hypocalcemia often seen in severe hypomagenesemia

What is Hyperphosphatemia? (PO_4^3-) Causes and symptoms.

Too much phosphate.

Causes: Acute and chronic kidney disease. Hypoparathyroidism (too much parathyroid hormone in the blood). Tumor lysis syndrome. Most patients asymptomatic.

Metastatic calcifications: excess phosphate taken up by vascular smooth muscle. Increased systolic BP. Small vessel thrombosis and painful nodules, skin necrosis.

Safe phosphate levels?

• Adult: 3.0-4.5 mg/dL or 0.97-1.45 mmol/L (SI units)

• Elderly: values slightly lower than adult.

• Child: 4.5-6.5 mg/dL or 1.45-2.1 mmol/L (SI units)

• Newborn: 4.3-9.3 mg/dL or 1.4-3 mmol/L (SI units

Hypophosphatemia symptoms and causes.

Hypophosphatemia: too little phosphate in the body

Causes: Weakness, ATP depletion. Respiratory muscle weakness. Bone loss osteomalacia (bone weakness)

Causes: Primary hyperparathyroidism. Low po4 from poor nutrition. Antacids. DKA - diabetic ketoacidosis

Hyponatremia (Na⁺) Symptoms

Symptoms: Coma, Anorexia, Lethargy, decreased tendon reflexes, limp muscles, seizures and stomach cramping.

Hyponatremia causes

Hypernatremia causes and symptoms

Symptoms: excessive thirst. Extreme fatigue. Muscle twitches and spasms

Causes: fluid loss

Links between different deficiencies.

Can’t correct K until Mg is corrected. Cause of Hypokalemia is Hypomagnesemia

Causes of Hypocalcemia is hyper/hypomagnesemia