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Chemical Biochemistry > Potassium > Flashcards

Potassium Flashcards

1
Q

What is the total body pottassium dependent on

A

Intake

Losses via kidney and gut

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2
Q

What are high potassium foods

A

Bananas

Pears

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3
Q

What happens in the serum after a potassium load

A

Potassium stimulates ATPase which causes the hormonal release of:

  • insulin
  • catecholamine
  • aldosterone
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4
Q

What happens in the urine after a pottasium load

A

Pottassium stimualtes renal cell utpake and secretion of potassium

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5
Q

Where in the nephron is pottassium handled

A 
Proximal tubule (60%)
Loop of henle  (ascending loop) (30%)
Distal tubule (10%)
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6
Q

What are the hormones involved in dealing with potassium load

A

Insulin
Catecholamine
Aldosterone

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7
Q

What is the role of insulin and catecholamine

A

Redistribute the pottassium from the extracellular to intracellular space to lower the serum pottasium

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8
Q

How does aldosterone lower the serum potassium

A

Promote renal excretion of potassium

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9
Q

What is the RAAS system when there is fluid depletion

A
  1. Fluid depletion causes underperfusion of renal glomerular (juxtaglomerular appratus)
  2. This switches on renin
  3. Renin cleaves angiotensin to angiotensin 2
  4. Angiotensin 2 stimualtes aldosterone release from the adrenal gland
  5. Aldosterone is released
  6. Aldosterone causes exchange of sodium for potassium and hydorgen
  7. This results in the loss of potassium and gain of sodium to draw water back in
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10
Q

What are the effects of an overactive RAAS on potassium

A

Hypokalaemia

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11
Q

When can you have an overactive RAAS

A

Primary aldosteronism- conns disease
Hypercortisol in cushings disease
Renal artery stenosis- this causes underperfsued juxtaglomerular appatus to release renin

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12
Q

What are the effects of an underactive RAAS on potassium

A

Hyperkalaemia

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13
Q

When can you see in overactive RAAS

A

Adrenal insufficiency
Ace inhibitors
Sprinolactone

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14
Q

How does insulin and catecholamine cause upake of potassium

A

Insulin and catecholamine drive the cellular uptake of potassium by acitvating the sodium pottassium ATPase

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15
Q

Where does insulin and catecholamine act

A

Liver
Skeletal muscle- catecholamine
Adipose tissue- insulin

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16
Q

When acid base is disrupted what happens to potassium

A

Also become distrupted

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17
Q

What is the effect of metabolic acidsosis on potassium

A

Hyperkalaemia

18
Q

What is the effect of metabolic alkalsosis on potassium

A

Hypokalaemia

19
Q

In metabolic acidosis why is there hyperkalaemia, what happens extra-renal

A

Acidosis i.e high hydroen cause hydrogen ions to enter the intracellular cells instead of potassium

20
Q

In metabolic acidosis why is there hyperkalameia, what is the action in renal

A

Hydrogen blocks potassium excretion therefore ECF potassium rises

21
Q

In metabolic alakalosis why is there hypokalaemia

A

Hydrogen ison move from intracellular cell to ECF as a buffer
Pottassium enters the cell to presever the electrochemical neutrality

22
Q

What are the ECG changes seen in hyperkalaemia

A

Tall peaked t wave
Widened WRS complex
Loss of p wave

23
Q

In insulin deficiency what happens to potassium

A

Pottassium moves from ICF to ECF

24
Q

What are the categorical causes of hyperkalaemia

A 
Increased uptake
Reduced excretion of potassium
Altered distribution
Factitious
Drugs
25
Q

What are the causes of increased uptake of potasssium

A

Oral

Iv therapy

26
Q

What are the causes of reduced excretion for hyperkalaemia

A

Renal failure
Mineralocoticoid deficiency- addisons
Tubular defects

27
Q

What are the causes of altered distribution in hyperkalaemia

A

Acidosis
Insulin deficiency
Crush injury

28
Q

What drugs can cause hyperkalaemia

A

Ace inhibitors
ARBs
Pottassium sparinf diuretics
Potassium supplements

29
Q

What are the consequences of hyperkaelmia

A

Neuromuscular: weakness, paralysis
Gi: nausea and vomiting and pain
Cardiovascular: conduction defects, arrythmia and cardiac arrest

30
Q

When is it an emergency for hyerpkalemia

A

When potassium is over 6.5

31
Q

What is the treatment for hyerpkalaemia

A

Protect the heart: calicum gluconate, ecg monitor, care with patient on digoxin
Redistribution of potassium: glucose and insulin, beta agonist, bicarbonate
Removal of potassium: loop diuretics, dialysis

32
Q

When is chronic hyperkalaemia caused

A

By CKD

33
Q

How do we treat chronic hyperkalaemia in CKD

A

Treat the underyling cause of ckd
Low pottasssium diet
Treat metabolic acidosis

34
Q

What are the causes of hypokalaemia

A

GI loss
Renal
Inadequate intake
Redistribution

35
Q

What are the causes of gi loss in hypokalaemia

A

Fistula
Diarhhoe
Tumour of the GI tract where bicarbonate is lost

36
Q

What are the renal causes of hypokalaemia

A

Diuretics
Renal tubular acidosis
Mineralocorticoid excess- cushings and conns

37
Q

What are the redistribution causes of hypokalaemia

A

Insulin
Alkalosis
Salbutamol

38
Q

What are the consequences of hypokalaemia

A

Skeletal muscle: weakness, paralysis
GI: paralytic ileus
Kidney: impaired concentrating ability, tubular defects
Cardiac: arrhythmia, digoxin toxicity

39
Q

What are the ECG changes in hypokalaemia

A 
Flattened t wave
St
Depression
Prominent p wave and prolonged pr interval
U waves
40
Q

What is the treatment of hypokalaemia

A

Non urgent
Oral treatment-3 bananas
Iv treatment

Chemical Biochemistry (5 decks)

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