{"id":4086,"date":"2010-08-10T10:00:03","date_gmt":"2010-08-10T14:00:03","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=4086"},"modified":"2013-06-12T23:16:18","modified_gmt":"2013-06-13T03:16:18","slug":"hypokalemia","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2010\/08\/hypokalemia\/","title":{"rendered":"Hypokalemia"},"content":{"rendered":"<p><strong>Pathophysiology<\/strong><\/p>\n<p><strong>1)<\/strong> decreased potassium levels &lt; 3.5 mmol\/L due to increased potassium losses, decreased potassium intake, shift of potassium intracellularly\u00c2\u00a0 Specific causes &#8211; <strong>2)<\/strong> K+ wasting diuretics (furosemide, thiazides) <strong>3)<\/strong> prolonged diarrhea or vomiting <strong>4)<\/strong> metabolic alkalosis <strong>5)<\/strong> excessive sweating <strong>6)<\/strong> hyperaldosteronism<\/p>\n<p><strong>Signs and Symptoms<\/strong><\/p>\n<p><strong>1)<\/strong> symptoms occur if plasma K+ is &lt; 3.0 <strong>2)<\/strong> weak and tired legs <strong>3)<\/strong> fatigue <strong>4)<\/strong> myalgias <strong>5)<\/strong> hypoventilation due to respiratory muscle weakness <strong>6)<\/strong> paralysis <strong>7)<\/strong> nocturia, polyuria, polydipsia<\/p>\n<p><strong>Characteristic Test Findings<\/strong><\/p>\n<p><em>EKG<\/em> &#8211; <strong>1)<\/strong> flattening of T waves <strong>2)<\/strong> presence of &#8220;u&#8221; waves<\/p>\n<p><strong>Associated Conditions<\/strong><\/p>\n<p><em>increased incidence with<\/em> &#8211; <strong>1)<\/strong> amphotericin B <strong>2)<\/strong> steroids <strong>3)<\/strong> laxative abuse <strong>4)<\/strong> theophylline <strong>5)<\/strong> tetracycline <strong>6)<\/strong> renal cell carcinoma <strong>7)<\/strong> Cushing&#8217;s syndrome <strong>8)<\/strong> treatment of diabetic ketoacidosis hypokalemia causes hypertension<\/p>\n<p><strong>Biochemistry<\/strong><\/p>\n<p>hypokalemia causes delayed ventricular repolarization<\/p>\n<p><strong>Treatment<\/strong><\/p>\n<p><strong>1)<\/strong> repletion either by mouth or IV (no more than 20 mmol\/h) <strong>2)<\/strong> correction of ongoing losses<\/p>\n<p><strong>Tips for USMLE<\/strong><\/p>\n<p><strong>1)<\/strong> any condition with high renin will have low potassium <strong>2)<\/strong> hypokalemia in setting of digitalis use can precipitate digitalis toxicity (even if levels are normal) <strong>3)<\/strong>\u00c2\u00a0 hypokalemia can precipitate hepatic encephalopathy in cirrhotics <strong>4)<\/strong> look for hypokalemia in any question with prolonged diarrhea or vomiting.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pathophysiology 1) decreased potassium levels &lt; 3.5 mmol\/L due to increased potassium losses, decreased potassium intake, shift of potassium intracellularly\u00c2\u00a0 Specific causes &#8211; 2) K+ wasting diuretics (furosemide, thiazides) 3) prolonged diarrhea or vomiting 4) metabolic alkalosis 5) excessive sweating 6) hyperaldosteronism Signs and Symptoms 1) symptoms occur if plasma K+ is &lt; 3.0 2) [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[63],"tags":[2681,2685,2306,2682,2684,2683],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.5 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Hypokalemia - InsideSurgery Medical Information Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/insidesurgery.com\/2010\/08\/hypokalemia\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Hypokalemia - InsideSurgery Medical Information Blog\" \/>\n<meta property=\"og:description\" content=\"Pathophysiology 1) decreased potassium levels &lt; 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