The BMP Skeleton Key Layout
How clinicians quickly sketch and interpret the basic metabolic panel
Additional Key Electrolytes
Electrolyte Disorders
🔑 BMP + Ca + Mg + PO4 Overview & Approach
Systematic approach to complete electrolyte interpretation
Complete Electrolyte Panel
- Master Skeleton Key: BMP + Ca + Mg + PO4 approach
- Systematic Review: Don't miss critical interactions
- Clinical Context: History trending and patterns
- Emergency Priorities: Life-threatening findings first
- Urinalysis Integration: The ultimate diagnostic key
🌊 Hyponatremia
Na+ < 135 mEq/L - Most common electrolyte disorder
- Emergency Protocol: RIB therapy (2024)
- Diagnostic: Urine osmolality key
- Correction: 4-8 mEq/L per 24h
- Risk Factors: Chronic, severe cases
🔥 Hypernatremia
Na+ > 145 mEq/L - Water deficit state
- Water Deficit: TBW × [(Na/140) - 1]
- Correction: ≤0.5 mEq/L/hr
- Volume Status: Hypo/Eu/Hypervolemic
- Monitoring: Neurologic status
⬇️ Hypokalemia
K+ < 3.5 mEq/L - Check magnesium first!
- Critical Step: Mg++ must be >1.7 mg/dL
- Replacement: PO preferred over IV
- ECG Changes: U waves, flattened T
- Complications: Arrhythmias, weakness
⚡ Hyperkalemia
K+ > 5.0 mEq/L - Cardiac emergency
- Stabilize: Calcium gluconate 30mL IV
- Shift: Insulin + D50 + Albuterol
- Remove: K+ binders or dialysis
- ECG: Peaked T, wide QRS
🦴 Calcium Disorders Reference
Comprehensive Ca++ Homeostasis Guide
- Complete physiology: PTH, Vitamin D, FGF23
- Hypocalcemia guide: Emergency protocols
- Hypercalcemia guide: VITAMINS TRAP mnemonic
- Drug interactions: Critical safety information
📉 Hypocalcemia
Ca++ < 8.5 mg/dL - Neuromuscular irritability
- Emergency: Ca-gluconate 1-2 amps IV
- Critical: Check Mg++ first!
- Signs: Chvostek, Trousseau
📈 Hypercalcemia
Ca++ > 10.5 mg/dL - "Stones, bones, groans"
- 2 Ps: Primary hyperPTH vs PTHrP
- Emergency: IV fluids + bisphosphonates
- VITAMINS TRAP: PTH-independent causes
📉 Hypomagnesemia
Mg++ < 1.8 mg/dL - The forgotten electrolyte
- Recognition: PPI use, alcoholism, diuretics
- Replacement: Must correct FIRST
- Priority: K+ refractory until Mg++ corrected
- Formulations: Citrate/gluconate preferred
📈 Hypermagnesemia
Mg++ > 2.6 mg/dL - Rare but dangerous
- Risk Factor: CKD + Mg-containing meds
- Emergency Antidote: IV Calcium
- Definitive: Saline diuresis, dialysis
- Monitor: DTRs, respiratory depression
🔍 Metabolic Acidosis & Acid-Base Analysis
Comprehensive acid-base disorders with systematic approach
- ABC Method: Systematic acid-base interpretation
- Anion Gap Analysis: MUDPILES vs USED CARP
- Delta-Delta Ratio: Mixed disorder detection
- UAG Differentiation: Renal vs GI causes
- Interactive Calculator: Complete analysis tool
🔍 Metabolic Alkalosis
Chloride-responsive vs resistant: The urine chloride key
- Urine Cl⁻ < 20: Volume/chloride depletion
- Urine Cl⁻ > 20: Ongoing mineralocorticoid activity
- Contraction Alkalosis: Pathophysiology explained
- Treatment Protocols: Saline vs cause-specific
- Interactive Calculator: Complete assessment tool
🧪 Phosphorus Disorders Reference
Comprehensive PO₄ Management Guide
- FGF23-Klotho axis: Modern understanding
- CKD-MBD: Complete pathophysiology
- Refeeding syndrome: Prevention protocols
- Binder comparison: Evidence-based selection
📉 Hypophosphatemia
PO₄ < 2.5 mg/dL - Energy crisis
- ⚠️ Refeeding: Life-threatening
- Severe <1.0: Respiratory failure risk
- Replace: IV if <2.0 mg/dL
📈 Hyperphosphatemia
PO₄ > 4.5 mg/dL - CKD complication
- Ca×PO₄ <55: Prevent calcification
- Binders: Take WITH meals
- Emergency: Tumor lysis syndrome
🌊 Comprehensive Hyponatremia Guide Available!
2024 evidence-based protocols including RIB therapy, correction science, and emerging treatments