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Medicine
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Potassium
HyperkalemiaHypokalemiaSerum K more than 5.5mEq/LSerum K less than 3.5mEq/LDefinition
(1 )Transcellular shiftAcidosis, Tumour lysis, blood transfusion and drugs.
(2 )Renal impairmentGFR drop below 10ml/min.
(1 )Transcellular shiftB2 agonist, Hypothermia, Alkalosis, Insulin.
(2 )Renal K lossDiuretics, Mg depletion, NG drainage
(3 )Extrarenal K lossDiarrhea
Etiology
(1 )ECG abnormalitiesPeaked T wave.1st degree heart block.Complete heart block.Ventricular fibrillation.
Muscle weakness, inversion T wave, Long QT interval.
Manifestations
(1 )Antagonize cardiac effects(1 )Estimate K deficit.(2 )Give20 mEq of KCL to 100ml of
isotonic saline over 1h through a large central vein.
Management
Hypokalemia
Definitions
Hypokalemia is a serum potassium concentration below 3.5 mEq/L Severe hypokalemia is a serum potassium concentration below 2.5 mEq/L
Causes
(1 )Transcellular shift: B2 agonist, alkalosis, hypothermia, insulin. (2) Renal Potassium Loss: diuretic therapy, Magnesium depletion. (3) Extrarenal Potassium Loss: diarrhea
Clinical Manifestations
(1 )Diffuse muscle weakness. (2) Prominent U waves, inversion of T waves, prolongation of the QT interval. (3) Hypokalemia alone does not produce serious ventricular arrhythmias.
Management