Potassium Regulation & Hypertension Cases (Small Group)

Question 1

What is pseudo hypokalemia?

Answer 1

Pseudohypokalemia is caused by leukocytosis. WBCs in test tube are metabolically active and they take in potassium to create a false hypokalemia.

Question 2

What are 4 types of hypokalemia that are a result of K redistribution?

Answer 2

1. Alkalosis
2. Beta-2 agonists
3. Insulin
4. Hypokalemic periodic paralysis (double check this one?)

Question 3

What are extra-renal causes of K loss? (4)

Answer 3

1. Villous adenoma (causes increased secretion of K)
2. Surgical drain
3. GI fistula
4. Diarrhea

*all GI

Question 4

What are renal causes of K loss? (5)

Answer 4

1. Primary hyperaldosteronism (can happen from cancer or tumor on adrenal gland)
2. Pseudohyperaldosteronism (cortisol can stimulate the receptor that aldosterone stimulates. typically, an enzyme breaks down cortisol so that it doesn’t stimulate the aldosterone receptor. However, patients that have a deficiency in this enzyme will get hyperaldosteronism but it is not from high aldosterone, it is from the cortisol.)
3. Licorice overconsumption
4. Bartter syndrome
5. Gitelman syndrome

Question 5

What are transcellular causes for hyperkalemia? (3)

Answer 5

1. Acidosis
2. Rhabdomyolysis
3. Beta blockers