Hypokalemia ☺️

Question 1

Main causes of hypokalemia

• alkalosis
• acidosis

Answer 1

Alkalosis

• vomiting
• thiazide, loop diuretics
• Cushings, Conns

Acidosis

• diarrhoea
• DKA, excess insulin

Reduced intake
-elderly

Mg deficiency

Question 2

Conns syndrome presentation, investigations and management

Answer 2

Conns => hyperaldosteronism

Generalised weakness, easy fatiguability

Renin:ALD ratio
AVS

High BP
Low K
High HCO3 due to chronic H movement out of cells
High urine K

Adrenal adenoma => surgery
Bilateral hyperplasia => spironolactone

Question 3

DKA presentation, investigations and management

-things to watch out for in management

Answer 3

Random blood glucose => high (above 3-5.5)
Urine ketones => high
Normal/high K

DKA => H into cells, K out

Fluid resus
Insulin => acts on NaK, hypokalemia
K admin

Question 4

Management

Answer 4

Manage underlying cause
PO/IV K replacement

K sparing diuretics if fluid overloaded

Question 5

ECG changes in hypokalemia

Answer 5

STUPR QT

ST depression
U waves
PR QT elongation

Question 6

Presentation of hypokalemia

Answer 6

7Ls

• lethargy
• low shallow resp, failure
• lethal cardiac dysrrythmias
• lots of urine - decreased response to ADH
• leg cramps
• limp muscles
• low BP