Nephrology Exam 2 (Electrolyte Disorders)
ACTUAL QUESTIONS AND CORRECT
ANSWERS
What roles does calcium play in the human body? - CORRECT ANSWERS✅✅- Cardiac
conduction
- Muscle contraction
- Bone homeostasis
99% of calcium is stored where? - CORRECT ANSWERS✅✅Them bones
Homeostasis is dependent on ____, which stores < _____% calcium - CORRECT
ANSWERS✅✅- ECF
- 0.5%
ECF calcium is ____% bound to what? - CORRECT ANSWERS✅✅- ~50%
- Albumin
Ionized calcium is essentially the same as what? - CORRECT ANSWERS✅✅Free calcium
What is the reference range of total calcium? - CORRECT ANSWERS✅✅8.5 - 10.5 mg/dL
What is the reference range of ionized calcium? - CORRECT ANSWERS✅✅1.12 - 1.32
mmol/L
If albumin is below what level, you need to calculate a corrected calcium level? - CORRECT
ANSWERS✅✅< 3.5 mg/dL
What is the corrected calcium formula? - CORRECT ANSWERS✅✅Measured Ca + [0.8 x
(4 - measured albumin)]
,What is measured calcium also known as? - CORRECT ANSWERS✅✅Total calcium (what
appears on BMP)
HJ is a 65-year-old male who is currently admitted to your hospital floor. Upon reviewing his
labs, you note the following:
Calcium level: 7.6 mg/dL
Albumin level: 1.5 mg/dL
Based on this patient's labs, does he qualify for the corrected calcium equation? Why? -
CORRECT ANSWERS✅✅- Yes
- Their albumin level is < 3.5 mg/dL
HJ is a 65-year-old male who is currently admitted to your hospital floor. Upon reviewing his
labs, you note the following:
Calcium level: 7.6 mg/dL
Albumin level: 1.5 mg/dL
What is this patient's corrected calcium level? Is it low, normal, or high? - CORRECT
ANSWERS✅✅- 7.6 + (0.8(4 - 1.5)) = 9.6 mg/dL
- Normal
What is the definition of hypercalcemia? - CORRECT ANSWERS✅✅- Total calcium >
10.5 mg/dL
- Ionized calcium > 1.32 mmol/L
A calcium level greater than what value is considered severe hypercalcemia? - CORRECT
ANSWERS✅✅- Total calcium > 13 mg/dL
- Ionized calcium > 3.5 mmol/L
What does hypercalcemia result from physiologically? - CORRECT ANSWERS✅✅-
Increased bone resorption
,- Increased GI absorption
- Increased tubular reabsorption from the kidneys
What are the signs and symptoms of hypercalcemia? - CORRECT ANSWERS✅✅-
Fatigue/weakness
- Anorexia
- Confusion
- Constipation
- Nephrolithiasis
- Cardiac changes
What are some cardiac changes that may be noted in a patient with hypercalcemia? -
CORRECT ANSWERS✅✅- Bradycardia
- Arrhythmias
What are some signs and symptoms associated with severe hypercalcemia? - CORRECT
ANSWERS✅✅- Acute renal failure
- Ventricular arrhythmias
- Sudden death
What are some causes of hypercalcemia? - CORRECT ANSWERS✅✅-
Hyperparathyroidism
- Cancer/malignancy
- Paget's disease
- Addison's disease
- Granulomatous diseases
- Hyperthyroidism
- Certain medications
What are some examples of granulomatous diseases? - CORRECT ANSWERS✅✅-
Tuberculosis
- Sarcoidosis
, - Histoplasmosis
What are some examples of medications that can cause hypercalcemia? - CORRECT
ANSWERS✅✅- Thiazide diuretics
- Estrogens
- Lithium
- Tamoxifen
- Vitamin A
- Vitamin D
- Calcium supplements
What are the treatment methods for an acute, ASYMPTOMATIC patient with hypercalcemia
(with calcium GREATER than 12 mg/dL and ionized calcium GREATER than 3 mmol/L)? -
CORRECT ANSWERS✅✅- Normal saline 200-300 ml/hr (may follow with loop diuretic)
- Bisphosphonate
- Calcitonin
- Corticosteroid
What are the treatment methods for an acute, ASYMPTOMATIC patient with hypercalcemia
(with calcium LESS than 12 mg/dL and ionized calcium LESS than 3 mmol/L)? - CORRECT
ANSWERS✅✅Observe, correct underlying cause
What loop diuretics may follow normal saline when treating a hypercalcemia patient? -
CORRECT ANSWERS✅✅- Furosemide
- Bumetanide
What are some examples of bisphosponates you can use when treating a hypercalcemia
patient? - CORRECT ANSWERS✅✅- Zoledronic acid
- Pamidronate
What are the treatment methods for an acute, SYMPTOMATIC patient with hypercalcemia
(WITH life-threatening symptoms)? - CORRECT ANSWERS✅✅- Normal saline 200-300
ml/hr (may follow with loop diuretic)
ACTUAL QUESTIONS AND CORRECT
ANSWERS
What roles does calcium play in the human body? - CORRECT ANSWERS✅✅- Cardiac
conduction
- Muscle contraction
- Bone homeostasis
99% of calcium is stored where? - CORRECT ANSWERS✅✅Them bones
Homeostasis is dependent on ____, which stores < _____% calcium - CORRECT
ANSWERS✅✅- ECF
- 0.5%
ECF calcium is ____% bound to what? - CORRECT ANSWERS✅✅- ~50%
- Albumin
Ionized calcium is essentially the same as what? - CORRECT ANSWERS✅✅Free calcium
What is the reference range of total calcium? - CORRECT ANSWERS✅✅8.5 - 10.5 mg/dL
What is the reference range of ionized calcium? - CORRECT ANSWERS✅✅1.12 - 1.32
mmol/L
If albumin is below what level, you need to calculate a corrected calcium level? - CORRECT
ANSWERS✅✅< 3.5 mg/dL
What is the corrected calcium formula? - CORRECT ANSWERS✅✅Measured Ca + [0.8 x
(4 - measured albumin)]
,What is measured calcium also known as? - CORRECT ANSWERS✅✅Total calcium (what
appears on BMP)
HJ is a 65-year-old male who is currently admitted to your hospital floor. Upon reviewing his
labs, you note the following:
Calcium level: 7.6 mg/dL
Albumin level: 1.5 mg/dL
Based on this patient's labs, does he qualify for the corrected calcium equation? Why? -
CORRECT ANSWERS✅✅- Yes
- Their albumin level is < 3.5 mg/dL
HJ is a 65-year-old male who is currently admitted to your hospital floor. Upon reviewing his
labs, you note the following:
Calcium level: 7.6 mg/dL
Albumin level: 1.5 mg/dL
What is this patient's corrected calcium level? Is it low, normal, or high? - CORRECT
ANSWERS✅✅- 7.6 + (0.8(4 - 1.5)) = 9.6 mg/dL
- Normal
What is the definition of hypercalcemia? - CORRECT ANSWERS✅✅- Total calcium >
10.5 mg/dL
- Ionized calcium > 1.32 mmol/L
A calcium level greater than what value is considered severe hypercalcemia? - CORRECT
ANSWERS✅✅- Total calcium > 13 mg/dL
- Ionized calcium > 3.5 mmol/L
What does hypercalcemia result from physiologically? - CORRECT ANSWERS✅✅-
Increased bone resorption
,- Increased GI absorption
- Increased tubular reabsorption from the kidneys
What are the signs and symptoms of hypercalcemia? - CORRECT ANSWERS✅✅-
Fatigue/weakness
- Anorexia
- Confusion
- Constipation
- Nephrolithiasis
- Cardiac changes
What are some cardiac changes that may be noted in a patient with hypercalcemia? -
CORRECT ANSWERS✅✅- Bradycardia
- Arrhythmias
What are some signs and symptoms associated with severe hypercalcemia? - CORRECT
ANSWERS✅✅- Acute renal failure
- Ventricular arrhythmias
- Sudden death
What are some causes of hypercalcemia? - CORRECT ANSWERS✅✅-
Hyperparathyroidism
- Cancer/malignancy
- Paget's disease
- Addison's disease
- Granulomatous diseases
- Hyperthyroidism
- Certain medications
What are some examples of granulomatous diseases? - CORRECT ANSWERS✅✅-
Tuberculosis
- Sarcoidosis
, - Histoplasmosis
What are some examples of medications that can cause hypercalcemia? - CORRECT
ANSWERS✅✅- Thiazide diuretics
- Estrogens
- Lithium
- Tamoxifen
- Vitamin A
- Vitamin D
- Calcium supplements
What are the treatment methods for an acute, ASYMPTOMATIC patient with hypercalcemia
(with calcium GREATER than 12 mg/dL and ionized calcium GREATER than 3 mmol/L)? -
CORRECT ANSWERS✅✅- Normal saline 200-300 ml/hr (may follow with loop diuretic)
- Bisphosphonate
- Calcitonin
- Corticosteroid
What are the treatment methods for an acute, ASYMPTOMATIC patient with hypercalcemia
(with calcium LESS than 12 mg/dL and ionized calcium LESS than 3 mmol/L)? - CORRECT
ANSWERS✅✅Observe, correct underlying cause
What loop diuretics may follow normal saline when treating a hypercalcemia patient? -
CORRECT ANSWERS✅✅- Furosemide
- Bumetanide
What are some examples of bisphosponates you can use when treating a hypercalcemia
patient? - CORRECT ANSWERS✅✅- Zoledronic acid
- Pamidronate
What are the treatment methods for an acute, SYMPTOMATIC patient with hypercalcemia
(WITH life-threatening symptoms)? - CORRECT ANSWERS✅✅- Normal saline 200-300
ml/hr (may follow with loop diuretic)
