American Board of Surgery Qualifying Exam (ABS QE) Practice Test

What electrolyte imbalances are associated with the use of Silver nitrate?

1. HypoNa, HyperCa, HyperK

2. HypoNa, HypoCl, HypoK

3. HyperNa, HypoCl, HyperK

4. HypoCa, HyperCl, HypoK

The correct answer is: HypoNa, HypoCl, HypoK

The use of silver nitrate can lead to several electrolyte imbalances due to its mechanism of action and the context in which it is typically used. Silver nitrate is often applied in situations involving cauterization or as an antimicrobial agent. One key aspect of its effect is that it can cause local tissue irritation and a chemical burn when used improperly, which may subsequently influence electrolyte levels, particularly sodium and chloride. Hypnatremia (low sodium) can occur due to local tissue injury causing fluid shifts and subsequent dilution of serum sodium levels. The application of silver nitrate may also lead to a loss of chloride ions, resulting in hypochloremia. Hypokalemia (low potassium) can happen because although silver nitrate itself does not primarily influence potassium levels, any associated fluid shifts or changes in urinary excretion due to tissue responses may lead to potassium wasting. Overall, the combination of low sodium, low chloride, and low potassium presents a plausible scenario regarding the electrolyte imbalances linked with silver nitrate use. Recognizing these associations is crucial for proper management in clinical settings where silver nitrate is utilized.