Hyperkalemia/Hypokalemia Flashcards

1
Q

Where is K mainly secreted?

A

principal cell

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2
Q

What 3 factors control K excretion?

A
  1. Incresed Na delivery to distal tubule–> increased Na absorption and K + H excretion
  2. alkalosis-> H reabsorption–>K excretion
  3. aldosterone
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3
Q

how does plasma tonicity lead to hyperkalemia?

A

hyperglycemia–> solvent drag–> water pulls K–> hyperkalemia

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4
Q

hyperglycemia and acidosis both cause hyperkalemia…what treats both?

A

insulin

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5
Q

rapidly producing tumor cells leads to hyperkalemia or hypokalemia?

A

hypokalemia

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6
Q

When should we check magnesium?

A

hypokalemia

magnesium blocks K excretion which means hypomagnesium = increased K excretion

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7
Q

When should we check urine chloride?

A

hypokalemia

metabolic alkalosis

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8
Q

Urine cl

A

saline responsive hypokalemia from hypovolemia (vomiting, NGT, )

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9
Q

Urine cl > 20 = what?

A

saline resistant hypokalemia from barters, gitelmans, diuretics

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10
Q

hyperkalemia, Uk

A

renal causes

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11
Q

hyperkalemia, UK>200, TTKG 8-10

A

extrarenal causes

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12
Q

hypokalemia, Uk>20, TTKG >7

A

renal losses

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13
Q

hypokalemia, Uk

A

GI losses

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14
Q

UK>30, TTKG>7, and hypertensive

A

primary hyperaldosteronism
secondary hyperaldosteronism
non-aldo mineralcorticoids
Liddle’s

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15
Q

UK>30, TTKG>7, normo/hypotensive, variable acid base?

A

Mg deficiency

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16
Q

UK>30, TTKG>7, normo/hypotensive, acidemia

A

DKA
RTA
amphotericin B

17
Q

UK>30, TTKG>7, normo/hypotensive, alkalosis

A

Ucl20- diuretics, barter’s, gitelman’s

18
Q

What are the causes of pseudohyperkalemia

A

severe leukocytosis/thrombocytosis/erythrocytosis, hemolysis during draw, processing delay, platelets release K during clotting process

19
Q

EKG of hyper K=

A

peaked T, wide QRS, prolonged PR interval, shortened QT, absent p waves

20
Q

Treatment for hyperkalemia?

A

cardioprtection- calcium gluconate and EKG monitor
K shifts- glucose+insulin, bicarb, B agonis
K net loss- kayexalate, diuretics, dialysis

C BIG KD2

21
Q

What is the basic algorithm for solving hypokalemia problems?

A
  1. defect in internal or external balance?
  2. renal or extrarenal losses?
  3. hypertensive or normotensive
22
Q

EKG of hypokalemia?

A

flat T
prominent U
depressed ST segment

23
Q

hyperkalemia neuromuscular changes?

A

ascending weakness, ileus

24
Q

what are some clinical manifestations of hypokalemia?

A

weakness, paralysis, rhabdo, HTN, ileus, nephrogenic DI

25
Q

Rx: for hypokalemia

A

not urgent unless complication- monitor EKG, serial [k]
check magnesium
if symptomatic IV KCl 10 meq/fr. 10 meq=.1 increase in [k]
if asymptomatic- oral K