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General Internal Medicine

Electrolyte disorders   

Questions discussed in this category

What is your approach to electrolyte repletion for patients hospitalized with cardiac and non-cardiac conditions?
For example, do you target K >4 and Mg >2?
2 Answers available
What factors influence your decision to start salt tablets, urea, or a vaptan first in the management of a patient diagnosed with SIADH?
3 Answers available
What is your approach to preventing exercise-associated hyponatremia?
3 Answers available
Do you recommend fluid restriction in addition to other management strategies for patients with hyponatremia due to SIADH?
6 Answers available
Do you routinely check serum phosphorus levels after IV iron therapy?
If not, are there specific instances where you would recommend checking phosphorus levels and at what frequency for monitoring/treatment?
2 Answers available
How do you approach a patient with biochemical evidence of primary hyperparathyroidism, but normal parathyroid scan?
5 Answers available
Do you try to treat the acidosis resulting from acetazolamide in patients with IIH?
1 Answer available
Do you interpret failure to develop hypernatremia with prolonged water deprivation (such as for 12 hours) as evidence against diabetes insipidus even if the urine osmolality is just below normal?
For a patient whose sodium remains 142 despite water deprivation from 8 pm to 8 am, with urine osm of about 500, is further testing needed?
2 Answers available
What is your approach to managing hypokalemia in patients with Bartter syndrome who are on high doses of potassium chloride but cannot tolerate amiloride or ACEi/ARBs due to low blood pressures?
1 Answer available
What further work up do you recommend for patients with a chronic high anion gap metabolic acidosis with normal eGFR who have been ruled out for lactic acidosis, ketosis, toxic alcohols, and other usual culprits of high anion gap metabolic acidosis?
3 Answers available
What are your next steps when managing patients with suspected Gitelman syndrome for whom genetic testing reveals variants of uncertain significance or novel mutations not well characterized?
2 Answers available
In SIADH due to malignancy, do you prefer to use free water restriction or salt tablets?
Or other therapy - e.g., tolvaptan? Free water restriction may hinder QOL. Salt tablets may raise levels more quickly but have risks of edema and hype...
1 Answer available
Is there a role for SGLT-2 inhibitors in the treatment of chronic hypomagnesemia?
1 Answer available
Do you recommend obtaining a spot urine or 24-hour urine magnesium measurement when evaluating patients with persistent hypomagnesemia of unknown etiology?
3 Answers available
What is your approach to using bisphosphonates in those with severe hypercalcemia and chronic kidney disease?
1 Answer available
Do you consider hyperuricemia as a potential etiology of an anion gap metabolic acidosis in patients with elevated uric acid levels and no other readily explainable causes of acidosis?
1 Answer available
What additional studies would you obtain for a patient with end stage kidney disease on hemodialysis who has persistent hypercalcemia and low PTH?
1 Answer available
Can an acid loading test be used to assist with the diagnosis of RTAs other than an incomplete distal RTA?
1 Answer available
Does your goal rate of correction in patients with chronic hypoosmolar hyponatremia differ based on the degree of hypoosmolarity?
4 Answers available
How do you treat sarcoidosis associated hypercalcemia in a patient with adenopathy and no other signs of systemic involvement?
1 Answer available
Do you prefer transtubular potassium gradient (TTKG) or urine potassium to urine creatinine ratio when evaluating patients with abnormal potassium levels?
1 Answer available


Papers discussed in this category

Clin Chim Acta, 2020 Oct 20
Diagnostic value of parameters from a spot urine sample for renal potassium loss in hypokalemia.
Am J Kidney Dis, 2019 Jun 19
Physiology and Pathophysiology of Potassium Homeostasis: Core Curriculum 2019.
Curr Opin Nephrol Hypertens, 2011 Sep
Intrarenal urea recycling leads to a higher rate of renal excretion of potassium: an hypothesis with clinical implications.
AACE Clin Case Rep, 2020 Aug 06
METHOTREXATE TREATMENT FOR SARCOIDOSIS-INDUCED HYPERCALCEMIA.
Am J Med, 1987 Jun
Hydroxychloroquine treatment of hypercalcemia in a patient with sarcoidosis undergoing hemodialysis.
Sarcoidosis Vasc Diffuse Lung Dis, 2012 Mar
Hypercalcemia from sarcoidosis successfully treated with infliximab.
Arch Osteoporos, 2017 Jul 19
Glucocorticoid sparing effect of zoledronic acid in sarcoid hypercalcemia.
BMJ Case Rep, 2022 Jul 08
Hungry bone syndrome like presentation following single-dose denosumab for hypercalcaemia secondary to sarcoidosis with IgA nephropathy.
Arthritis Res Ther, 2014 Mar 24
Bone fragility in sarcoidosis and relationships with calcium metabolism disorders: a cross sectional study on 142 patients.
JAMA, 2012-01-11
Serum potassium levels and mortality in acute myocardial infarction.
Mayo Clinic proceedings, 2015 Aug
Dysmagnesemia in Hospitalized Patients: Prevalence and Prognostic Importance.
Circulation, 2017 Oct 03
Update to Practice Standards for Electrocardiographic Monitoring in Hospital Settings: A Scientific Statement From the American Heart Association.
Heart rhythm, 2017 Oct 30
2017 AHA/ACC/HRS guideline for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society.
The New England journal of medicine, 2025 Aug 29
Increasing the Potassium Level in Patients at High Risk for Ventricular Arrhythmias.
JAMA,
Effects of Iron Isomaltoside vs Ferric Carboxymaltose on Hypophosphatemia in Iron-Deficiency Anemia: Two Randomized Clinical Trials.
PloS one, 2016 Dec 01
Choice of High-Dose Intravenous Iron Preparation Determines Hypophosphatemia Risk.

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