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Y4R3 - Medicine II 🩺 > L6: Potassium Disorders > Flashcards

L6: Potassium Disorders Flashcards

1
Q

Levels of K

A
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2
Q

High Intracellular concentration of K+ is necessary for several cellular functions.

A

…

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3
Q

Routes for K+ excretion

A

Routes for K+ excretion are:
- The KIDNEY (primary route).
- The colon.

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4
Q

Renal Handling of Potassium

A

Renal handling of K+ involves
① Filtration
② Reabsorption
③ Secretion.

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5
Q

Renal Handling of Potassium

  • Filtration
A

K+ is freely filtered at the glomerulus.

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6
Q

Renal Handling of Potassium

  • Reabsorbtion
A
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7
Q

Renal Handling of Potassium

  • Secretion
A
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8
Q

Factors affecting K Execretion

A
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9
Q

Renal Handling of Potassium

  • Intake
A
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10
Q

Renal Handling of Potassium

  • hormones
A
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11
Q

Renal Handling of Potassium

  • Acid-Base Balance
A
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12
Q

Renal Handling of Potassium

  • Anions
A
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13
Q

Renal Handling of Potassium

  • Diuretics
A
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14
Q

Def of Hypokalemia

A

Serum potassium level < 3.5 mEq/L.

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15
Q

Psedo-Hypokalemia

A
  • Hypokalemia is the result of K+ uptake by white blood cells when the sample is stored at room temperature. WBC (>75 x 109/L) as in AML (acute myeloid leukemia).
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16
Q

Etiology of Hypokalemia

A
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17
Q

Etiology of Hypokalemia

  • Insufficient Intake
A
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18
Q

Etiology of Hypokalemia

  • Intracellular Shift
A
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19
Q

Def of Hypokalemic periodic paralysis

A
  • A rare inherited disorder characterized by episodes of muscle weakness in one or more limbs accompanied by low serum K+ levels
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20
Q

Types of Hypokalemic periodic paralysis

A

① Familial Periodic Paralysis
② Thyrotoxic Periodic Paralysis.

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21
Q

Etiology of Hypokalemic periodic paralysis

A
  • Autosomal dominant inheritance
  • spontaneous mutations
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22
Q

Potential triggers of Hypokalemic periodic paralysis

A
  • Physical activity
  • Night rest
  • High carbohydrate diet
  • Alcohol intake
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23
Q

Etiology of Hypokalemia

  • Renal Loss
A
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24
Q

Etiology of Hypokalemia

  • Renal Loss (Drugs)
A

① Diuretics (thiazides - loop diuretics - osmotic diuretics).
② Beta-2 adrenergic agonists.
③ Glucocorticoids.
④ Catecholamines

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25
Q

Etiology of Hypokalemia D2 Renal Loss

  • Hypokalemic Disorders
A
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26
Q

Etiology of Hypokalemia D2 Renal Loss

  • Hypokalemic Disorders (Hypertensive)
A
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27
Q

Etiology of Hypokalemia D2 Renal Loss

  • Hypokalemic Disorders (Hypotensive)
A
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28
Q

Etiology of Hypokalemia

  • Non-Renal Loss
A
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29
Q

Most common causes of hypokalemia

A

① Losses caused by diuretics
② Gastrointestinal disorders.

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30
Q

CP of Hypokalemia

A
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31
Q

CP of Hypokalemia

  • manifestations of the cause
A

E.g., Cushing’s syndrome.

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32
Q

CP of Hypokalemia

  • Manifestations of Hypokalemia
A
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33
Q

CP of Hypokalemia

  • Neuromuscular
A
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34
Q

CP of Hypokalemia

  • CVS
A

① Arrhythmias
② Abnormal contractility
③ Potentiation of digitalis toxicity

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35
Q

CP of Hypokalemia

  • metabolic
A
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36
Q

CP of Hypokalemia

  • Renal
A

① Nephrogenic diabetes insipidus
② Chronic tubulointerstitial nephritis.

37
Q

Dx of Hypokalemia

A
38
Q

Dx of Hypokalemia

  • Serum Potassium Level
A

Serum K+ <3.5 mEq/l means hypokalemia.

39
Q

Dx of Hypokalemia

  • ECG
A
40
Q

Dx of Hypokalemia

  • Determine Cause
A
41
Q

Dx of Hypokalemia

  • Algorithm
A
42
Q

Algorithm for Dx of Hypokalemia

  • Urine K
A
43
Q

Algorithm for Dx of Hypokalemia

  • After Checking BP
A
44
Q

Algorithm for Dx of Hypokalemia

  • Normal BP with decreased HCO3
A
45
Q

Algorithm for Dx of Hypokalemia

  • Normal BP with Increased HCO3
A
46
Q

Algorithm for Dx of Hypokalemia

  • Increased BP with Increased Renin & Increased aldosterone
A
47
Q

Algorithm for Dx of Hypokalemia

  • Increased BP with Decreased Renin & Increased aldosterone
A
48
Q

Algorithm for Dx of Hypokalemia

  • Increased BP with decreased Renin & decreased aldosterone
A
49
Q

TTT of Hypokalemia

A
50
Q

TTT of Hypokalemia

  • repletion of K
A
51
Q

Repletion of K in Hypokalemia

  • Mild
A
52
Q

Repletion of K in Hypokalemia

  • Moderate
A
53
Q

Repletion of K in Hypokalemia

  • Severe
A
54
Q

High concentrations of IV potassium can cause local venous irritation and potentially lead to cardiac arrhythmias.

A

…

55
Q

TTT of Hypokalemia

  • TTT Cause
A
56
Q

Def of Hyperkalemia

A

Serum K+ >5.5 mEq/L.

57
Q

Pseudo-Hyperkalemia

A

Cells release K+ in vitro due to:
- Thrombocytosis
- Severe leukocytosis
- RBCs hemolysis (e.g., trauma from tourniquet application).

58
Q

Etiology of Hyperkalemia

A
59
Q

Etiology of Hyperkalemia

  • high Intake
A

① Diet - Supplements.
② K+ containing salt substitutes.

60
Q

Etiology of Hyperkalemia

  • Transcellualr Shift of K+
A
61
Q

Etiology of Hyperkalemia

  • Impaired Renal Excretion
A
62
Q

Hyperkalemia D2 Impaired Renal Excretion

  • primary Renal Disease
A

◈ Acute kidney injury (especially severe oliguric AKI)

◈ Advanced CKD.

63
Q

Hyperkalemia D2 Impaired Renal Excretion

  • Hyperkalemic renal tubular acidosis (RTA)
A
64
Q

Hyperkalemia D2 RTA

  • Decreased aldosterone secretion
A
65
Q

Hyperkalemia D2 RTA

  • decreased aldosterone responsivness
A
66
Q

CP of Hyperkalemia

A
67
Q

CP of Hyperkalemia

  • Asymptomatic
A

…

68
Q

CP of Hyperkalemia

  • symptomatic
A
69
Q

CP of Hyperkalemia

  • Neuromuscular
A
70
Q

CP of Hyperkalemia

  • Cardiac
A
  • Arrhythmias (e.g., heart block - ventricular fibrillation).
  • Palpitations.
71
Q

CP of Hyperkalemia

  • Metabolic
A

Metabolic acidosis (non-anion gap).

72
Q

CP of Hyperkalemia

  • GIT
A

Nausea or vomiting.

73
Q

Dx of Hyperkalemia

A
74
Q

Dx of Hyperkalemia

  • Serum Potassium Level
A
75
Q

Dx of Hyperkalemia

  • ECG
A
76
Q

Dx of Hyperkalemia

  • Earliest Sign in ECG
A

Peaked T Wave

77
Q

Dx of Hyperkalemia

  • Changes in waves/intervals/segments
A
78
Q

Dx of Hyperkalemia

  • Arrhythmias
A
79
Q
  • There is a weak correlation between serum K+ levels & the severity of ECG changes.
  • Findings are more likely to occur with rapid-onset hyperkalemia.
A

…

80
Q

Dx of Hyperkalemia

  • Investigations of the cause
A
81
Q

Dx of Hyperkalemia

  • ABG
A

Blood gases often shows metabolic acidosis.

82
Q

TTT of Hyperkalemia

A
83
Q

TTT of Hyperkalemia

  • COUNTERACTING MEMBRANE EFFECTS OF HYPERKALEMIA
A
84
Q

TTT of Hyperkalemia

  • PROMOTING CELLULAR UPTAKE OF K+
A
85
Q

TTT of Hyperkalemia

  • OTHER MEASURES
A
86
Q

TTT of Hyperkalemia

  • Remove K from Body
A

① Potassium-lowering resins (potassium binders) or
② Loop diuretics or
③ Dialysis (to remove K+ rapidly in patients with kidney impairment).

87
Q

TTT of Hyperkalemia

  • Medications & supplements review
A

① Discontinue or modify dosing of medications that may be contributing to hyperkalemia.

② Stop K+ containing salt substitutes & K+ supplements.

88
Q

TTT of Hyperkalemia

  • Diet
A

Low K+ diet.

89
Q

TTT of Hyperkalemia

  • Follow up
A

Repeat potassium regularly until it is within normal range.

Y4R3 - Medicine II 🩺 (20 decks)

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