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diagnosis causes management acidosis algorithm alkalosis chloride comparison effects elevation gitelman high hyperkalemia hypokalemia lactated lr metabolic normal ns pathophysiology
Lactated Ringers (LR) vs Normal Saline (NS) - Comparison Composition of LR: • Sodium 130 mEq/L •
130 mEq/L • Potassium ... /L of sodium lactate ... NOT lactic acid ... decreased renal blood flow ... Decreased GFR, urine
Causes of Lactate Elevation, Lactic Acidosis - Differential Diagnosis The most common causes of hyperlactatemia are usually:
Acidosis - Differential ... excretion (e.g., urine ... liver or renal injury ... LV failure - Low ... #typea #typeb #classification
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
alkalosis • Normal/low ... ketoacidosis • D-lactic ... and potassium acid ... #Algorithm #nephrology ... #differential #
Rhabdomyolysis - Differential Diagnosis Framework and Management Summary Causes of Rhabdomyolysis: • Trauma: - Immobilization - Crush injury - Compartment
Rhabdomyolysis - Differential ... Weakness - Dark urine ... Isotonic fluid/Lactated ... Monitor potassium ... causes #treatment #nephrology
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
thiazide-sensitive sodium ... alkalosis • Normal or low ... Hypocalciuria (spot urine ... ratio 0.5%) Differential ... Syndrome #diagnosis #nephrology
Causes of Hyperkalemia l. Pseudohyperkalemia A Cellular efflux; thrombocytosis, erythrocytosis, leukocytosis, in vitro hemolysis B.
neuromuscular injury ... Drug-associated: heparin, low-molecular-weight ... #Hyperkalemia #Differential ... Diagnosis #High #Potassium ... #Classification
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