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Hypokalaemia (Symptoms (Aetiology (Reduced dietary K intake,…
Hypokalaemia
Symptoms
Aetiology
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GI losses - caused by vomiting, severe diarrhoea and laxative abuse
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Treatment Plan
Mild - K > 2.5 mmol/L
- Give oral K supplement
- If on thiazide diuretic and K > 3 mmol/L then consider a K sparing diuretic
Severe - K < 2.5 mmol/L
- IV K - but give cautiously and no more the 20mmol/h
- DO NOT GIVE K if oliguric (very small volume of urine output)
- Never give K as a fast stat bolus dose
Acute can resolve on own, majority just need withdrawal from diuretics or laxatives
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Pathophysiology
Increased aldosterone secretion due to increased renal excretion - results in K loss as Na is exchanges for K
Cushings' - excess cortisol which can have effect on mineralocorticoid thus excess aldosterone - pathophysiology is unclear
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Investigations
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ECG
- Small or inverted T waves, prominent U waves (after T waves), a long PR interval, depressed ST segments