#hyperkalemia

[walvitswordsandpoems]

Medicine - symptoms of HYPERKALEMIA = too much potassium in blood (negative effects).

Hiperkaliemia, hiperkalemia, hiperpotasemia – u człowieka stan, w którym stężenie jonów potasowych K+ w surowicy krwi przekracza przyjętą (umowną) wartość 5,5 mmol/l.

[sciencesolutions]

[pochapal]

getting shipped off to urgent care again ^_^

[samreensway]

CRITICAL CARE SCENARIO OF RENAL FAILURE 

CRITICAL CARE SCENARIO OF RENAL FAILURE MRCS B OSCE - MOCK EXAM Bli medlem i kanalen för att få åtkomst till flera förmåner: https://www.youtube.com/channel/UCkkvon_blxinTHc7DGuYkpQ/join

[okekep]

Potassium level is 3.5 to 5.2mEq/L

[ecgkid]

Effect of Hyperkalamia (High Blood potassium) on Heart

[swagging-back-to]

vegans can you please lmk how much potassium you get from one meal??? im worried i get too much and i limit myself to like 1-2 meals a day (that arent filling) bc of it

i get around 2400-2700 mg of potassium with a meal, mostly from quinoa. bc one cup of quinoa has like 1200 mg of potassium (which is fucking insane)

just wanna know if other vegans are in the same ballpark as me or if i have way too much

[craigslisthorses]

Hyperkalemic Periodic Paralysis (HYPP)

Breeds with HYPP; Quarter Horses, American Paint Horses, Appaloosas, and Quarter Horse Crosses.

HYPP

"An inherited disease of the muscle, caused by a genetic defect. A mutation in the sodium channel gene. Sodium channels are pores in the muscle cell membrane which control contraction of the muscle fibers. When the defective sodium channel gene is present, the channel becomes “leaky” and makes the muscle overly excitable and contract involuntarily. The channel become “leaky” when potassium levels fluctuate in the blood. This may occur with fasting followed by consumption of a high potassium feed such as alfalfa. Hyperkalemia, which is an excessive amount of potassium in the blood, causes the muscles in the horse to contract more readily than normal. This makes the horse susceptible to sporadic episodes of muscle tremors or paralysis."

GENOTYPE

HYPP Positive= H/N and H/H

HYPP Negative= HYPP N/N

HYPP horses with H/N genotype means they are heterozygous carriers, carrying one copy of the HYPP gene. If you bred a mare who is H/N to a stallion who is N/N, you would have about a 50% chance the foal is H/N as well. However if you bred an H/N mare to an H/N stallion you will have about a 25% chance the foal being N/N, a 50% chance it will be H/N, and a 25% chance it will be H/H.

HYPP horses with the H/H genotype means it is homozygous, carrying both copies of the HYPP gene. 100% passing the HYPP gene to it's offspring.

I made a thing in case it helps the visual learners out there

IMPRESSIVE (but not really)

Let's talk about the QH stallion, Impressive. All horses that have a HYPP positive gene of any kind, all descend from this horse. Impressive sired 2,250 foals and they estimate he has around 50,000 living descendants. No dilution of lineage will remove HYPP, as it is a dominant trait and will show whether you are 5 generations back or 2.

HYPP SYMPTOMS

HYPP varies in severity, it's not always equal and every horse may have different reactions. HYPP can be confused for tying-up or even colic, they may have difficulty breathing, muscle tremors, sweating, weakness, tremors. In more severe cases the horse may collapse from paralysis of the muscles in the airway and can result in sudden death.

Not every horse who is HYPP positive may display symptoms, making this disease sometimes hard to detect.

IS IT CURABLE?

No. HYPP may be managed with diet and certain medicines for maintenance but it cannot be cured. H/H positive horses have poor prognosis and can be much more difficult to manage.

VIDEOS OF HYPP ATTACKS

CW: Horses in distress, videos may be hard to watch for some.

Video 1

Video 2

Video 3

Video 4

Video 5

Sources (and if you want to read more); AAEP , UCDavis, Tri-State

Is there anything I forgot? Anything to add? Just covering the basics of this disease and what it does to these horses.

[toastbastard]

rewatching 911 2x18

- god i love abuela and pepa

- being with eddie is what’s best for christopher. that being established so early on is so important to me. this episode changed the show fundamentally. i stand by that.

- eddie is a car guy. or at least he knows the inside of a car. i can’t remember if he ever worked as a mechanic in the gap between the army and LAFD. or he just knows about cars bc that’s something that a lot of people know about.

- I love this arc so much.

- “was evan buckley in that fire truck?” - my roomate when the truck blew up. also her “let me triage him” (we’re both in healthcare)

- they lowkey could have made his leg crush look better. it lowkey looks like he could just wiggle out with the way they did it. obviously not actually crushing oliver starks leg with a truck. but you know what i mean

- “shoot me if you have to” bobby i swear to god

-the fact that eddie is actively grieving throughout this episode is so crazy. but also he put his grief on hold because he had to be there for christopher.

- god “we’re out of time cap” god god this fucking show

- buck is so hurt. i can’t emphasize how fucking bad this would be. he was so close to just. fucking dying. If i was on shift and i heard that report of buck coming in thinking Oh Fuck. I’m thinking rnhabdomylosis. hyperkalemia (like maddie said) which can make your heart stop. tissue perfusion is fucked. he’s gonna go into shock if not already. he’s probably gonna code. it’s crazy that he didn’t code (go into an unstable rhythm/loose his pulse/fucking die). anyways.

- buck panicking when he wakes up. he’s so young. he’s so young and he’s so hurt.

- “he didn’t know if i would ever work again” the way he didnt care about anything else is devastating.

- this arc is such a well-written way to develop bucks character. i honestly love it.

[ssiggss]

OP OC TOUR

>:^P there are so many so we'll start on my two ladies on the whitebeard crew!

Salt and Pepper were inseparable best friends long before they joined the crew, and long before they ate their fruits! I'm still working on the lore surrounding their recruitment, but some info abt them:

They both talk in 3rd person- that's their character gag! They've never stopped doing this and never will. An example would be if Salt wanted to play a card game, she'd ask like "Salt wants to play that card game. it's her favorite!"

They are incredibly intelligent and are strategists! (I headcanon that Izou's division deals with strategy/coordination, these ladies work under him)

Pepper has photographic memory!

Both of them provide Thatch with an endless supply of basic seasoning, of which he's very grateful for- one small detail is that everyone can always tell when he's used their salt and pepper versus organic. It's not gross, just a difference!

Salt has a crush on Jozu. She wants that man SO bad.

Ms. Whoopsie Daisy is a sword fishwoman who is famous for her beautiful singing voice and being a philanthropist with a specific interest in archeology, history, and the preservation of it!

I don't have a solid story for her yet, but I do know she is very sweet with a penchant for being dramatic.

Merena is a veritable genius when it comes to all things mechanical, having grown up in a family full of academic prodigies.

In a childhood tragedy, she lost both of her legs, and made herself a new pair that have various other applications.

Her arms are usually armored with specially fit mech-arms, also her own invention.

Is on the run from the government bc she does NOT want to work for them and they want her expertise so bad- unaware she is from a family they silenced years ago.

Lost one of her lower tusks after a harsh fall down the side of a mountain- tells people she lost it in a fight with a sea-king.

Taseum inherited his devil fruit, coming from a long line of knights whose sole goal is to protect the queen of his country- a country that fell to ruin a very long time ago.

His father was a terrible person, generally taught his son that he'd already failed in life and that being a true knight wasn't something he could achieve.

Taseum didn't want to believe that and wanted nothing more than to prove he could be someone important, someone who protected people. But, after years to training and dedication, when he went to join the marines because he was always told the marines were a beacon of justice and hope- he was humiliated as the head of the program laughed them off the island when he tried. Because who needs banana powers.

Taseum is now a jaded, bitter vigilante who is seen as a very strange but oddly terrifying force. Like no one is afraid of the man with banana powers until you suddenly have hyperkalemia and die from a heart attack.

Maddox is an ex crew member of Sephone End- a tyrannical pirate crew on the downlow payroll of the world gov to control a specific island she re-named Endhouse.

He couldn't stand how she and the rest of the crew treated the civilians- terrorizing them, enslaving them. This wasn't why he set out to sea, nor what he joined her crew for.

He left shortly after Endhouse was established, and spent a while dodging government agents and Margo Carnage, Sephone's tactician and assassin.

He has knowledge about many things the five elders don't want getting out- but he is extraordinarily difficult to catch.

Maddox is a HUGE flirt, NO ONE except the obvious are safe from this man

Very levelheaded!

Trained to use armament and observation haki to the point its ridiculous. Doesn't have conquerors bc the man would be genuinely unstoppable

Eythos D. Diefaro is a legendary man from the blank century, who followed his good friend, Joyboy. During his time, he was seen as a hero, despite the attempts of those who considered him an enemy.

He is the first angel fruit user to ever pledge loyalty to a person, and the only one until Kasey- who joins the Strawhat crew.

His character bit is the 'blinding smile.' When he smiles at people its like looking into the sun.

He was such an honorable and compassionate person that no matter what kind of lies his enemies told about him, he'd undo it in like. A day.

Is the most patient person to have ever existed. This man does not lose his temper for no reason.

Eve Undying is the first angel fruit user EVER.

She was a giant, whose home was destroyed and consumed by a monstrous sea king- this guy was so massive it had swallowed islands whole before.

She didn't want to see the kingdom of tiny people get demolished and swallowed up as hers had been, so she fought the thing for seven entire days.

Even when the monster nearly bit her in half and her guts were falling out, she held it off. When it retreated for a moment to lick its wounds and come back, that was when she received her fruit.

Eve is very quiet but very humorous, and she LOVES jokes. Puns, dad jokes, you name it.

Lost her arms in an entirely different life threatening situation- after that, used her powers to generate arms made of water.

Tiedori is a gnowoman whose people once lived in a magical land that is now myth, and grew up on Endhouse, under Sephone's tyrannical rule.

The gnofolk have important knowledge about angel fruit users that the world gov doesn't want to lose, but equally don't want on the loose- hence why they've employed Sephone.

Tiedori befriend the 'blessed vessel' she came to know as Phoebe, who almost died three times defeating Sephone.

Tiedori was inspired to set sail herself, and follow her dreams of finding her people's homeland, eventually ending up on Dressrosa and meeting Kasey, having no idea the two angel fruit users were related.

She is fiery, scrappy, and WILL pick a fight with someone ten times bigger than her. It does cause issues for her, but she also has naturally good luck, and always makes it out somehow.

I haven't included Sephone End and her crew here bc I don't have current references for them and my old art is actually heinous they NEED a revamp STAT.

[justkidneying]

Blocking the Neuromuscular Junction

Neuromuscular blocking agents (NMBAs) stop transmission at the junction between nerves and muscles, which will cause partial or complete paralysis. Why do we want to do this? The main reason is to cause paralysis for starting endotracheal intubation (relax throat muscles), surgery (keep the patient still), and for putting people on ventilators (stop them from fighting against the machine).

You might also give someone an NMBA if they are coughing up blood, having a severe asthma attack, have high intracranial pressure, or are shivering with hypothermia.

There are two types of these drugs and they work two different ways, though they are all given intravenously.

Depolarizing NMBAs

So to initiate muscle contraction, our body uses a transmitter called ACh. When this binds to a receptor, some ions move around and the muscle contracts. This is called depolarization. After some time, the cell can repolarize as ACh is digested by the enzyme AChE.

The main depolarizing NMBA is Succinylcholine. This also binds to the same receptor, causing muscle contraction. However, it is not digested by AChE, so the cell cannot repolarize. The muscle will keep contracting until it runs out of calcium ions and relaxes. The muscle is paralyzed after that because the receptor is still blocked. Only when the serum enzyme BChE digests it can we reactivate the muscle.

Succinylcholine is mostly used for intubation. It only lasts for a few minutes, which is good because once you trach someone you don't need to paralyze their throat anymore.

The main risks of this drug are hyperkalemia (potassium exits the cell when the muscle is depolarized), muscle pain, hyperthermia, and increased intraocular pressure. Succinylcholine is contraindicated in burn patients.

Nondepolarizing NMBAs

These drugs also act on the ACh receptor, though they do not activate it. The most common ones are atracurium, cisatracurium, vecuronium, and rocuronium. I'll go through a few important notes on each one.

Atracurium (an isoquinoline) is metabolized into the active laudanosine, which has a stimulating effect on the central nervous system and can cause seizures. It also increases histamine, which can cause flushing. Cisatracurium is also an isoquinoline, but it does not cause an increase in histamine or break down into laudanosine. Both of these can be reversed using neostigmine to up the concentration of ACh and outcompete them at the receptor.

Rocuronium and vecuronium are both aminosteroids. Rocuronium has a quick onset and is great for rapid sequence intubation. It also does not require dosage adjustment for those with renal impairment. Vecuronium is slower, and needs to be adjusted for those with renal and liver impairment. These can both be reversed with sugammadex, which will form a complex that can be pissed out. The only thing with sugammadex is that it can cause bradycardia, decrease the effectiveness of contraceptives, and increase the risk of bleeding.

The adverse effects of all of the nondepolarizing NMBAs are apnea, hypotension, and electrolyte imbalance. You also need to increase the dose for those with burns and trauma. These drugs also interact with volatile anesthetics, increasing their effects. However, this is actually a favorable effect, as it lowers the dose of anesthetic required.

Using These Drugs

The main thing to remember here is that NMBAs do not cause sedation or amnesia. You must use them with things like propofol, midazolam, benzodiazepines, opioids, etc. I will repeat: DO NOT USE THESE DRUGS ALONE. The patient will be paralyzed but CONCIOUS and AWARE. For the love of medicine, please. The reason I say this is because I have seen paramedics give "problem patients" a paralytic without a sedative in some sick sort of revenge. Fuck them. I don't care what a patient did, that is not okay to do. Still makes me mad just thinking about it.

Anyways, so these are one part of the drugs required for surgery. If you just sedate someone, they'll still move around, and you don't want that while you are cutting on them.

Writing Tips

There isn't too much to say here, but I think it is important for people to know these drugs exist and only paralyze, not sedate. So shit, if you wanna write some crazy horror stuff happening, you can just have someone be paralyzed. Or also this is how people can be aware during surgery. I think there was a big case about this a few years ago. Sensation is still intact when these drugs are given alone, so go forth and torture people I guess (??) - IN FICTION

Anywho, that's all, thanks for reading. Maybe I will write soon about intubation, sedatives, and other stuff like that. Kinda neuro (which one the poll).

[lover-of-mine]

Sorry Anna, coming back to this - it could honestly mean nothing, but again it's interesting nonetheless (at least to me). So Aspirin (Naproxen) is not an anticoagulant (blood thinner) it is an antiplatelet agent (prevents adhesion of platelets already in the blood). It helps with mild pain, mostly arthritis (think Aleve, in the U.S).

Anticoagulants (like Warfarin) work in your Liver by preventing the creation of Vitamin K (Potassium) which clots the blood. A contraindication for Naproxen, is if you have high levels of Vitamin K in your blood which could cause adverse effects to the patient when taken.

The reason I mention this is because in 3x04 when Buck is invited to Athena and Bobby's for dinner, he says he can't have one of the side dishes (collard greens, I think), because they are high in Vitamin K and he is currently on blood thinners. Typical people can have collard greens just fine even on a blood thinner (unless they are eating it every day), but for Buck to say that makes me think that he has Hyperkalemia, which is why the blood clotting was such an issue and presented itself months after surgery.

So the curse could still very well be a thing they could just say made him break out in boils, rather than an allergy, however the ibuprofen of it all is still (in my eyes) significant because he shouldn't be taking it because of (potential) Hyperkalemia. But again, this is just me giving a context and backstory that may be incredibly irrelevant lmao.

Anyway, you don't have to post - but, if you do, hopefully this will call off any "Tommy is not a killer' mob (which, in Tommy's own words: "I never said that.")

Oh damn. This is fascinating shit. I love that there's more textual evidence with the naproxen of it all being a thing. This is insane. I don't know if this is on purpose or a happy accident, but I will live in this world. Someone else did point out to me that the aspirin thing might be a separate thing, I was just lost on Google with that one lol. But I love this theory for real. I am choosing to believe this.

[ask-doctor-wombat]

how do u react to shitty pickup lines

With my own shitty pickup lines.

Hey girl, are you hyperkalemia? Because you make my heart skip a beat!

Are you a primary spontaneous pneumothorax? Because you take my breath away!

Are you nitrous oxide? Because when I'm in your presence, I can't think straight!

Are you uncontrolled hypertension? Because you make my heart grow!

Are you Helicobacter pylori? Because you make my stomach feel funny.

And then she walks away :-/

[snarp]

I am trying so hard not to get hyponatremia and hyperkalemia and no one respects my efforts. My research skills. The rigor of my experiments. Save-a-Lot generic "Cheez-It"s snack crackers are, scientifically scored on multiple metrics, superior to both the Wal-Mart version and the actual brand. But I know you don't care.

[selkiesongss]

my body is a machine that turns tomatoes into hyperkalemia

[iloveyoutony]

best part of watching the pitt is now i understand all the medical terms and i know exactly what they're doing <3 when he was like yeah that guy's too young to have an MI i was like ohhh it's probs rhabdo and smth wrong w his electrolytes and then he was like oopsie it's hyperkalemia - EXACTLY