Potassium Disorders Flashcards

1
Q

What is the normal range of potassium in the serum?

A

4-5 mEq/L

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2
Q

Is there more potassium outside or inside the cells?

A

inside (98% intracellular)

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3
Q

What are the symptoms of potassium disorder?

A

cramps, weakness, paralysis, cardiac arrythmias

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4
Q

What changes would you see on EKG for hyperkalemia vs hypokalemia?

A

hyper: ST depression, T wave elevation! U wave
hypo: T wave depression
both: PR prolongation and QRS widening

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5
Q

How is Dig related to potassium levels?

A

hypokalemia increases Dig toxicity causing hyperkalemia

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6
Q

What are the main 4 factors that dictate potassium distribution and excretion?

A

1 concentration
2 acid base (acid out, basic in)
3 insulin/catecholamines (in)
4 Aldosterone (increase excretion)

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7
Q

What are some causes of hypokalemia?

A

1 increased entry into cells (met acidosis, increased insulin, beta agonist)
2 GI loss (vomiting, diarrhea)
3 urinary loss (diuretic, salt wasting)

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8
Q

How do you distinguish between a GI and renal cause of hypokalemia?

A

24 hr urinary K+:
UK+ decrease: GI
UK+ increase: renal

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9
Q

What are the main complications of hypokalemia?

A

cardiac arrhythmia, rhabdomyolysis, renal dysfn, HTN

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10
Q

When treating hypokalmia, what other electrolyte imbalance should you also check?

A

Mg+2 (low Mg+2 = increased excretion of K+)

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11
Q

Main causes of hyperkalemia are shift of K+ out of cells and decreased excretion. Name 2 examples of each.

A

1 shift out of cells (muscle breakdown, hyperlgycemia/DKA, metabolic acidosis)
2 decreased excretion (hypoaldosteronism, renal failure/NSAIDs/HIV/ACEi decrease renin, Aldosterone resistance-K+ sparing diuretics)

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12
Q

How do you differentiate pseudohyperkalemia from a “true” hyperkalemia clinically?

A

EKG changes along with increased K+ on electrolyte for true hyperkalemia

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13
Q

What are the 3 steps for treating hyperkalemia?

A

1 calcium - raise RMP/depolarize
2 shift K+ into cells- insulin/glucose, NaHCO3, beta agonist(ALbuterol)
3 remove K+- loop diuretics, Kayexalate, dialysis

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