wk 4 - Potassium

Question 1

The reference range of potassium in plasma is —-.

a) 3.5 – 4.5 mmol/L
b) 135-145 mmol/L
c) 3.5-135 mmol/L
d) 4.5-145 mmol/L
e) 3.5-145 mmol/L

Answer 1

a) 3.5 – 4.5 mmol/L

Question 2

1. excess insulin concentration
2. high concentration of catecholamines
3. alkalosis

all cause what?

Answer 2

Hypokalemia - due to Internal redistribution of K⁺ from extracellular (ECF) to intracellular (ICF) space

Question 3

What do you expect potassium level to be when blood is hemolysed?

a) Hyperkalemia
b) Hypokalemia
c) Pseudohypokalemia
d) Pseudohyperkalemia

Answer 3

d) Pseudohyperkalemia

Question 4

Conn’s syndrome can result in _____kalemia.

Answer 4

Conn’s syndrome can result in hypokalemia.

Question 5

Hyperaldosteronism can result in ____kalemia.

Answer 5

Hyperadosteronism can result in hypokalemia.

Question 6

In plasma, ________ concentration is high and ________ concentration is low compared to inside the cell.

Answer 6

In plasma, sodium concentration is high and potassium concentration is low compared to inside the cell.

Question 7

Addison’s syndrome is characterised by ____aldosteronism.

Answer 7

Addison’s syndrome is characterised by hypoaldosteronism.

Question 8

• Low urine
• Loss of bicarbonate — Acidosis
• Loss Na+ — Hyponatremia — Hyperkalemia

are symptoms of ___________

Answer 8

low GFR, leading to renal failure

Question 9

Diabetic patients are _____ likely to be hypokalemic.

Answer 9

Diabetic patients are less likely to be hypokalemic.

Question 10

Acidosis, hyperkalemia and hyperglycemia can all occur at the same time due to what?

Answer 10

Diabetes (type 1 & 2)

Question 11

1. Hyperaldosteronism (Conn’s)
2. increased sodium and water excretion (such as diuretic use)
3. alkalosis
4. high potassium diet

will all ________ potassium excretion in urine.

Answer 11

Hyperaldosterone, increased sodium and water delivery (such as diuretic use), alkalosis and high potassium diet will increase potassium excretion in urine.

Question 12

In medicine, a disease is considered ___________ if a patient is a carrier for a disease or infection but experiences no symptoms.

Answer 12

In medicine, a disease is considered asymptomatic if a patient is a carrier for a disease or infection but experiences no symptoms.

Question 13

• GI tract poor intake
• Excess GI loss (diarrhoea & vomiting)
• Excess renal loss (diuretic)
• Transmembrane redistribution

can all be the cause of ___________

Answer 13

hypokalemia

Question 14

• Hypoglycemia
• Alkalosis
• Hypernatremia
• Conn’s syndrome
• Renal Tubular acidosis

are all characteristics of _____kalemia

Answer 14

hypokalemia

Question 15

Acidosis is followed/accompanied by ____________ to maintain electroneutrality

Answer 15

Acidosis is followed/accompanied by hyperkalemia to maintain electroneutrality

Question 16

Hypokalemia could result due to ____ insulin and alkalosis.

Answer 16

Hypokalemia could result due to high insulin and alkalosis.

Question 17

______ is the liquid part of the blood after coagulation, devoid of clotting factors as fibrinogen.

Answer 17

serum is the liquid part of the blood after coagulation, devoid of clotting factors as fibrinogen.

Question 18

Aldosterone and cortisol _______ renal sodium reabsorption (hypernatremia) and ________ potassium renal reabsorption (hypokalemia)

Answer 18

Aldosterone and cortisol increase renal sodium reabsorption (hypernatremia) and decrease potassium renal reabsorption (hypokalemia)

Question 19

In _______, sodium concentration is high and potassium concentration is low compared to ________

Answer 19

In plasma (ECF), sodium concentration is high and potassium concentration is low compared to inside the cell (ICF)

Question 20

The concentration of potassium in plasma is normally ______ than inside the cell.

Answer 20

The concentration of potassium in plasma is normally lower than inside the cell.

Question 21

In case of hyperglycemia, glucose enters the cell with _________ in Na/K ATPase pump

Answer 21

In case of hyperglycemia, glucose enters the cell with potassium in Na/K ATPase pump

Question 22

Leukocytosis, phelobotomy (tight application of tourniquet) and hemolysis of blood samples are all possible reasons for _________kalemia.

Answer 22

Leukocytosis, phelobotomy (tight application of tourniquet) and hemolysis of blood samples are all possible reasons for Pseudohyperkalemia.

Question 23

Tissue injury could result in _____kalemia.

Answer 23

Tissue injury could result in hyperkalemia.

Question 24

What do you expect plasma potassium concentration to be when blood has been collected in K2EDTA?

a) Hyperkalemia
b) Hypolkalemia
c) Pseudohypokalemia
d) Pseudohyperkalemia

Answer 24

d) Pseudohyperkalemia

(artefactual = inaccuracy due to systemic error)

Question 25

A severe weakness and increased excitability may be regarded to \_\_\_\_\_\_\_\_\_\_\_

Answer 25

A severe weakness and increased excitability may be regarded to **hypokalemia.**

Question 26

The concentration of sodium in plasma is normally ______ than inside the cell.

Answer 26

The concentration of sodium in plasma is normally **higher** than inside the cell.

Question 27

insulin increases the cell's uptake of ________ and \_\_\_\_\_\_\_\_\_\_

Answer 27

insulin increases the cell's uptake of **glucose** and **potassium**

Question 28

how does fasting affect plasma potassium.

Answer 28

it has no effect - only insulin is decreased due to hypoglycaemia

Question 29

in case of plasma **acidosis**, potassium is more likely to ________ in plasma.

Answer 29

in case of plasma acidosis, potassium is more likely to **increase** in plasma.

Question 30

Insulin ________ cellular uptake of plasma potassium.

Answer 30

Insulin **increases** cellular uptake of plasma potassium.

Question 31

Diuretics (low/decreased ADH) lead to ________ **(excess renal loss)** and loss of K+

Answer 31

Diuretics (low/decreased ADH) lead to **Polyuria** (excess renal loss) and loss of K+

Question 32

when a sample of blood is taken, there could be more potassium in serum than in blood due to what?

Answer 32

rupture of palettes during coagulation process.

Question 33

Severe renal impairment may be due to \_\_\_\_\_aldosteronism

Answer 33

Severe renal impairment may be due to **hypoaldosteronism**

Question 34

\_\_\_\_\_ GFR can result in Hyperkalemia

Answer 34

Low GFR can result in Hyperkalemia

Question 35

What do you expect plasma potassium level to be after blood is drawn? a) Hyperkalemia b) Hypokalemia c) Pseudohypokalemia d) Pseudohyperkalemia

Answer 35

d) Pseudohyperkalemia | (due to leakage from RBC)

Question 36

In general, an increase in potassium is associated with acidosis. Exceptions are in case of diarrhoea/vomiting, causing a loss of bicarbonate and potassium, which leads to... a) Acidosis and hyperkalemia b) Acidosis and hypokalemia c) Alkalosis and hyperkalemia d) Alkalosis and hypokalemia

Answer 36

b) Acidosis and hypokalemia

Question 37

* Insulin deficiency * Acidosis * Low catecholamines * Cell lysis can all cause \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

Answer 37

**Hyperkalemia** - due to internal (transmembrane) redistribution of K+ ions

Question 38

\_\_\_\_\_\_\_\_\_ can be caused by an **excessive** limit of aldosterone and cortisol that can block renal __________ of filtered potassium. a) Hypokalemia b) Hyperkalemia c) Absorption d) Reabsorption

Answer 38

**Hypokalemia** could be caused by an excessive limit of aldosterone and cortisol that can block renal **Reabsorption** of filtered potassium.

Question 39

in case of plasma **alkalosis**, potassium is more likely to ________ in plasma.

Answer 39

in case of plasma alkalosis, potassium is more likely to **decrease** in plasma.

Question 40

Internal redistribution resulting in **hyperkalemia** could be due to the following EXCEPT: a) Acidosis b) Aldosterone c) Cell lysis d) Insulin deficiency e) Low catecholamines

Answer 40

b) Aldosterone

Question 41

The reference range of sodium in plasma, is normally-----. a) 3.5 – 4.5 mmol/L b) 135-145 mmol/L c) 3.5-135 mmol/L d) 4.5-145 mmol/L e) 3.5-145 mmol/L

Answer 41

b) 135-145 mmol/L

Question 42

Aldosterone and cortisol ________ the amount of K+ reabsorbed/going from the kidney to blood.

Answer 42

Aldosterone and cortisol **decrease** the amount of K+ reabsorbed/going from the kidney to blood.

Question 43

In the sodium/potassium ATPase pump, ___ sodium ions leave the cell whereas, ___ potassium ions enter the cell.

Answer 43

In the sodium/potassium ATPase pump, **3 sodium ions** leave the cell whereas, **2 potassium ions** enter the cell.

Question 44

In order to **decrease** pseudohyperkalemia, it is recommended to store the blood at \_\_\_ºC rather than at 4ºC

Answer 44

In order to decrease pseudohyperkalemia, it is recommended to store the blood at 37ºC rather than at 4ºC

Question 45

Alkalosis is followed/accompanied by ____________ to maintain electroneutrality

Answer 45

Alkalosis is followed/accompanied by **hypokalemia** to maintain electroneutrality

Question 46

**Hypokalemia** is proportional to ____ plasma insulin.

Answer 46

Hypokalemia is proportional to **high** plasma insulin.

Question 47

in case of plasma **alkalosis**, potassium is more likely to _______ in plasma.

Answer 47

in case of plasma alkalosis, potassium is more likely to **decrease** in plasma.

Question 48

K+ Levels higher in serum than in plasma are due to the release of K+ from rupture of _______ during the coagulation process

Answer 48

K+ Levels higher in serum than in plasma are due to the release of K+ from rupture of **platelets** during the coagulation process

Question 49

in case of plasma **acidosis**, potassium is more likely to _______ in plasma.

Answer 49

in case of plasma acidosis, potassium is more likely to **increase** in plasma.

Question 50

hypokalaemia (alkalosis) will be followed by _________ Ions exiting the cell to maintain electroneutrality & _________ pH

Answer 50

hypokalaemia (alkalosis) will be followed by **Hydrogen** Ions exiting the cell to maintain electroneutrality & **decrease** pH

Question 51

* Hyperglycemia * Acidosis * Hyponatremia * Addison’s syndrome * Low GFR are all characteristics of \_\_\_\_\_kalemia

Answer 51

hypokalemia

Question 52

low aldosterone and cortisol that can stimulate renal reabsorption of filtered potassium is a possible cause of \_\_\_\_\_kalemia

Answer 52

low aldosterone and cortisol that can stimulate renal reabsorption of filtered potassium is a possible cause of **hyperkalemia**

Question 53

Heart arrest or no heartbeat are possible symptoms of \_\_\_\_\_\_\_\_\_\_\_

Answer 53

Heart arrest or no heartbeat are possible symptoms of **hyperkalemia**

Question 54

Hypoaldosterone, decreased sodium and water delivery, acidosis and low GFR will ________ potassium excretion in urine.

Answer 54

Hypoaldosterone, decreased sodium and water delivery, acidosis and low GFR will **decrease** potassium excretion in urine.

Question 55

What do you expect potassium concentration to be when blood has been stored at 4ºC for long time? a) Hyperkalemia b) Hypokalemia c) Pseudohypokalemia d) Pseudohyperkalemia

Answer 55

d) Pseudohyperkalemia

Question 56

insulin ________ plasma potassium

Answer 56

insulin **decreases** plasma potassium (high insulin = hypokalemia) (insulin utilises K⁺ to take up glucose into the cell)

Question 57

diabetic patients are ____ likely to be hypokalemic

Answer 57

diabetic patients are **less** likely to be hypokalemic (type 1 & 2 diabetes both prevent insulin from uptaking glucose, this normally requires potassium & therefore is left in the ECF/plasma = hyperkalemia)

Question 58

high plasma insulin will likely indicate a _____ plasma potassium (\_\_\_\_kalemia)

Answer 58

high plasma insulin will likely indicate a **low plasma potassium (hypokalemia)**

Question 59

insulin _______ cellular uptake of plasma potassium

Answer 59

insulin **increases** cellular uptake of plasma potassium

Question 60

fasting will ________ plasma potassium (\_\_\_\_\_kalemia)

Answer 60

fasting will **increase** plasma potassium (**hyperkalemia**)

Question 61

in type 2 diabetes, the patients insulin sensitivity is low - how does this affect plasma glucose & potassium?

Answer 61

hyperglycemia & hyperkalemia (insulin cannot shuttle glucose into the cell & therefore doesnt require the potassium cofactor, leaving them both in excess in the ECF)

Question 62

1. high excitability 2. muscle weakness/cramps 3. cardiac conduction abnormality 4. atrial/ventricular arrhythmia are all symptoms of \_\_\_\_\_\_kalemia

Answer 62

**hypokalemia**

Question 63

1. poor GI tract intake (due to starvation/anorexia) 2. excess GI loss (faeces - diarrhoea/vomitting) 3. excess renal loss (urine - from diuretics) 4. transmembrane redistribution (due to high insulin = uptake into the ICF) are all possible causes of \_\_\_\_\_kalemia

Answer 63

hypokalemia

Question 64

excess aldosterone & cortisol does what to plasma potassium?

Answer 64

the both increase reabsorption of Na⁺ , in turn blocking renal absorption of K⁺ ## Footnote **= hypokalemia**

Question 65

heart arrest or asystole (no heart beat) can be caused by \_\_\_\_\_kalemia (low excitability)

Answer 65

hyperkalemia

Question 66

acidosis and hyperglycemia are likely to cause \_\_\_\_\_\_kalemia

Answer 66

hyperkalemia - potassium follows hydrogen ions = acidosis - potassium enters the cell with glucose & insulin, if there is excess glucose in the ECF, then its likely potassium will be in excess in the ECF also

Question 67

when blood is drawn, which blood component will contain the most potassium?

Answer 67

**serum** - contains platelets/clotting factors that rupture, releasing potassium - plasma does not contain platelets & therefore does not coagulate/clot

Question 68

1. hemolysis 2. leukocytosis (due to leukaemia) 3. phlebotomy can all cause what?

Answer 68

**pseudohyperkalemia** - due to rupture of cells