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nephrology diagnosis management differential hyperkalemia causes acidosis aniongap diuresis excretion hypernatremia k metabolic methotrexate nongap pharmacology rhabdomyolysis sodium toxicity
Hyperkalemia Treatment Options Stabilize cardiac membrane: • IV Calcium (peaks 5-10 minutes) Decrease potassium concentration: • IV Fluids Shift
Hyperkalemia Treatment ... concentration: • IV Fluids ... (if preserved renal ... function) - Loop diuretic ... #nephrology
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
; High-Ceiling Diuretics ... Tolvaptan) • Treatment ... #Diuresis #Nephrology ... #Pharmacology #Medications ... #Table
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
phlebotomy High ... • K sparing diuretics ... (Uncontrolled diabetes ... Medications 2. ... #high #nephrology
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
phlebotomy High ... • K sparing diuretics ... (Uncontrolled diabetes ... Medications 2. ... #high #nephrology
Hyperkalemia - Diagnosis and Management - GrepMed Handbook S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Etiology: • Medications ... 15 suggests ↓ renal ... Elimination (see Table ... STOP offending medications ... #potassium #nephrology
Causes of High-anion Gap and Non-anion Gap Metabolic Acidosis Causes of High-anion Gap Acidosis: • Lactic acidosis
Causes of High-anion ... Acidosis Causes of High-anion ... Ketoacidosis: Diabetic ... Potassium-sparing ... diuretics (amiloride
Hypernatremia - Differential Diagnosis and Treatment Hypernatremia is almost always due to unreplaced water loss (free water
urine osm (in DI; high ... , Dehydration: neurologic ... unavailable 2) Osmotic Diuresis ... post-obstructive 3) Diabetes ... with isotonic fluids
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary Causes of Rhabdomyolysis: • Trauma: - Immobilization - Crush injury - Compartment
Treatment of underlying ... Monitor potassium ... per day until stable ... Loop diuretics for ... #nephrology
Hyperkalemia Management Pseudohyperkalemia: 1. Hemolyzed sample 2. Blood drawn from a site/line where potassium or TPN is
hours) - Increase renal ... excretion via a loop diuretic ... (give with fluids ... Hyperkalemia #Management #treatment ... #potassium #high
Methotrexate Renal Toxicity Prevention: • Alkalinize the urine, keep urine ph >7 • Start pre-treatment 12
Methotrexate Renal ... bicarbonate based fluids ... alkalosis • Forced diuresis ... clearance but high ... #nephrology
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