1: Fluid + Electrolyte - Hypokalaemia

Question 1

What are the two causes of hypokalaemia

Answer 1

• Loss Potassium

- Intracellular shift potassium

Question 2

What are the 4 broad-categories of potassium loss

Answer 2

1. Renal-Loss
2. Extra-renal Loss
3. Medication
4. Other

Question 3

What are two renal causes of potassium loss

Answer 3

Conns

Cushings

Question 4

What are two extra-renal causes of hypokalaemia

Answer 4

Diarrhoea

Vomitting

Question 5

What two medications can cause hypokalaemia

Answer 5

Glucocorticoids

Liquorice

Question 6

What is another cause of hypokalaemia

Answer 6

Low magnesium

Question 7

What 3 things may cause hypokalaemia due to increasing intracellular shift

Answer 7

Insulin
Alkalosis
Salbutamol (B2 Agonist)

Question 8

What are 3 symptoms of hypokalaemia

Answer 8

• Arrhythmias
• Muscle weakness: hypotonia, hyporeflexia
• Constipation

Question 9

What is first-line investigation in hypokalaemia

Answer 9

ECG

Question 10

What will be seen on ECG in hypokalaemia

Answer 10

• Flattened T waves
• ST depression
• U wave

Question 11

What is the u wave

Answer 11

small wave following T-wave in lead V2

Question 12

What defines mild hypokalaemia

Answer 12

<2.5 and asymptomatic

Question 13

How is mild hypokalaemia managed

Answer 13

Oral potassium supplements

Question 14

What defines severe hypokalaemia

Answer 14

> 2.5 or symptomatic

Question 15

How is severe hypokalaemia managed

Answer 15

IV Potassium

Question 16

What should IV potassium never be given as and why

Answer 16

Stat dose - if administered too quickly it causes vein damage and arrhythmias

Question 17

When should IV potassium not be given

Answer 17

Oliguric

Question 18

If interventions to correct potassium have been given, however it remains low, what is the likely cause

Answer 18

Low magnesium