What this deck covers
Sodium and Potassium Disorders in Children in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.
Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.
The 18 cases, in order
- The first thing to look at
- The bag that dropped the sodium
- Fitting at one hundred and sixteen
- Corrected too well, too fast
- Concentrated urine, low sodium
- Treating it by giving less
- Losing weight and losing salt
- Twelve days old and very dry
- Low sodium, very high sugar
- Pink blood, high number
- Collapsed in the second week
- Alkalotic with a low urine chloride
- Flat T waves and a quiet abdomen
- Replacement that will not work
- Too much water in the sachet
- Low after the nebulisers
- Which one cannot wait
- Shocked, and very dry
Diagnoses and management options tested
Across the 18 cases you are asked to choose between options such as: The serum osmolality alone, Switch to an isotonic maintenance fluid, Fluid restriction alone, The correction has been too slow, Cerebral salt wasting, Oral salt supplements with free access to water, Diabetes insipidus, Rapidly, with free water, over 6 hours, It is genuinely low and needs hypertonic saline, Give calcium gluconate immediately without waiting, Congenital adrenal hyperplasia with salt loss, Bartter syndrome, Oral supplements alone, as he is tolerating fluid, The magnesium is low and must be corrected first.
Clinical pearls from this deck
- Saline helps one kind of hyponatraemia and harms another; the examination tells you which.
- Hypotonic maintenance fluid in a postoperative child is a preventable cause of brain injury.
- In acute symptomatic hyponatraemia the danger in the first hour is under-treatment, not over-correction.
- Osmotic demyelination shows itself days later, after the child has apparently recovered.
- Concentrated urine in the face of a low sodium is inappropriate by definition; that is the whole diagnosis.
- Saline can lower the sodium further in this syndrome; the kidney keeps the water and dumps the salt.
Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.
More from this system: all nephrology case decks · pediatric reference values.
