essential for nerve & muscle function, acid/base balance, formation of rbcs, atp, bones & teeth
What are functions of phosphorus?
respiratory acidosis
This can cause a shift of phosphorus out of the cells.
respiratory alkalosis
This can cause a shift of phosphorus into the cells.
increases GI absorption, movement of phosphorus out of the bone, promotes renal excretion
How does PTH influence phosphorus?
True
Serum phosphate is under tight physiological control. T/F?
hypophosphatemia
<2.5 mg/dL phosphate = ?
critically ill
Hypophosphatemia is most common in ________.
insulin, glucose, carbs
Which compounds can cause Phosphorus to move from blood and into cells due to metabolic demands?
tissue repair, decreased: magnesium, potassium, hyperparathyroidism, thiazide
What are some causes of hypophosphatemia?
phosphorus binding antacids, vomiting, diarrhea, malabsorption, vitamin d deficiency
What can cause decreased absorption of phosphorus in hypophosphatemia?
aluminum, calcium, magnesium
What are our phosphorus binding antacids?
DKA treatment, severe burns, alcohol, alcohol withdrawal
Combination causes of hypophosphatemia?
d
Which medication can cause hypophosphatemia?
a) propanolol
b) penicillin g
c) cefalosporin
d) laxative
multifactorial
The causes of hypophosphatemia in critically ill patients are considered _______.
decreased grip strength, seizure, chest pain, respiratory muscle weakness, bleeding, hemolysis, difficulty speaking, risk of infection
Signs & symptoms of acute hypophosphatemia?
cyanosis, joint stiffness, osteomalacia
Signs & symptoms of chronic hypophosphatemia?
NaPhos, KPhos
Treatment of severe hypophosphatemia?
neutraphos, iv phosphorus
Treatment of mild hypophosphatemia?
tumor lysis syndrome
-hyperphosphatemia is considered secondary to this condition and should be treated promptly.
tumor lysis syndrome, cell turnover, acute celluar shift
Endogenous Hyperphosphatemia?
DKA, hyperglycemia, lactic acidosis
What conditions can cause acute cellular shift?
release of phosphate
What is cellturnover?
exogenous
What is considered more rare; endogenous or exogenous hyperphosphatemia?
c
_______ can lead to acute phosphate nephropathy.
a) phosphate binders
b) KPhos
c) Laxatives
d) NaPhos
a,d
Which of the following is a potential cause of hyperphosphatemia?
a) volume depletion
b) calcium supplements
c) smoking
d) fertilizer poisoning
respiratory/metabolic acidosis, dka, leukemia, lymphoma, trauma, chemo, rhabdomyolysis
What conditions can cause hyperphosphatemia?
hypocalcemia
Hyperphosphatemia & _______ have associated symptoms.
soft tissue calcification, oliguria, irregular hr
Symptoms of metastatic diseased hyperphosphatemia?
c
Which treatment medication is a phosphate binder used to treat hyperphosphatemia?
a) aluminum
b) calcium
c) renvela
d) vitamin d
b
Which antacid is preferred in renal failure caused by hyperphosphatemia?
a) aluminum
b) calcium
c) magnesium
d) potassium
Dialysis
_________ may be necessary in severe acute hyperphosphatemia, with symptompatic hypocalcemia