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Electrolyte Imbalaces, Sammer Sheikh - Coggle Diagram

- - - - PTHrP from the tumour e.g. squamous cell lung cancer
      - bone metastases
      - myeloma - due primarily to increased osteoclastic bone resorption caused by local cytokines e.g. IL, tumour necrosis factor, released by the myeloma cells
    - - sarcoidosis
      - Vit D intoxication
      - acromegaly
      - thyrotoxicosis
      - Milk-alkali syndrome
      - dehydration
      - Addisons disease
      - Pagets disease of the bone - usually normal in this condition but hypercalcaemia can occur with prolonged immobilisation
- - - - e.g. carpopedal spasm, tetany, seizures, or prolonged QT interval
      - IV calcium replacement with IV calcium gluconate 10mn of 10% solution over 10 mins
      - ECG monitoring
- - - - Addison's disease
      - diuretics - thiazides, loop diuretics
      - diuretic stage of renal failure
    - - SIADH - urine osmolarity > 500 mmol/kg
      - hypothyroidism
  - - - diarrhoea, vomiting, sweating
      - burns
      - adenoma of rectum
    - - secondary hyperaldosteronissm - heart failure, liver cirrhosis
      - nephrotic syndrome
      - IV dextrose
      - psychogenic polydipsia
  - - - isotonic saline 0.9% NaCl
      - if serum sodium falls, alternative diagnosis is more likely e.g. SIADH
    - - fluid restrict to 500-1000ml/day
      - demeclocycline
      - vaptans
    - - fluid restrict to 500-1000ml/day
      - loop diuretics
      - vaptans
- - - - beta blockers - in renal failure patients
      - potassium sparing diuretics
      - ACE inhibitors
      - ARB's
      - spironolactone
      - ciclosporin
      - heparin - unfractionated and LMWH (inhibition of aldosterone secretion)