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Hypophosphatemia vs. Hyperphosphatemia

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Topic updated on 12/26/15 1:14am

HYPOphosphatemia HYPERphosphatemia
  • A 35 year-old who is being treated for nephrolithiasis develops diffuse weakness
 
Introduction Introduction
  • Causes include
    • hyperparathyroidism
    • osmotic diuresis
    • excessive IV glucose
    • treatment of DKA
    • refeeding syndrome in alcoholics
  • Causes include
    • usually iatrogenic
    • rhabdomyolysis
    • hypoparathyroid
    • hypocalcemia
Presentation Presentation
  • Symptoms
    • diffuse muscle weakness
    • flaccid paralysis
      • due to decreased ATP production
  • Symptoms
    • heart block
    • soft tissue calcification
Evaluation Evaluation
 
  • EKG findings
    • heart block
Treatment Treatment
  • Replace
    • potassium phosphate
    • sodium phosphate
  • Decrease dietary phosphorous
  • Aluminum hydroxide
  • Hydration and acetazolamide
  • Dialysis
Prognosis, Prevention, and Complications Prognosis, Prevention, and Complications
  • If severe may cause
    • rhabdomyolysis
    • hemolysis
 


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Qbank (1 Questions)

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(M2.RL.1) A 32-year-old man with a history of chronic alcoholism presents to the ED with vomiting and diarrhea for 1 week. On physical exam, he is found to have orthostatic hypotension and dry mucus membranes. Laboratory results show serum sodium, potassium, chloride, bicarbonate, BUN, creatinine, glucose, calcium, magnesium, and phosphate within normal limits. The patient is treated with IV administration of normal saline, dextrose, thiamine, and folic acid. The following day he complains that he feels too weak to move his arms or legs. Which of the following is the most likely explanation for his new onset weakness? Topic Review Topic

1. Hypomagnesemia
2. Hypoglycemia
3. Hyponatremia
4. Hypophosphatemia
5. Hypocalcemia

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