HYPOKALEMIA(electrolyte imbalance)

HYPOKALEMIA

  • It is a low level of potassium(k ๋) in blood serum
  • normal potassium level 3.5 - 5mmol/L
  • Death can occur due to  respiratory muscle paralysis

CAUSES:
  • Decrease intake
  • Alkalosis : Potassium shift into cells
  • Sympathomimetics stimulation - trauma, thyrotoxic periodic paralysis, beta 2 agonist toxicity(salbutamol)
  • Renal loss - excess aldosterone = conn's syndrome,bilateral adrenal hyperplasia, ascites , CHF                   - Barter's , Gitelman syndrome                                                                                                       - Salt wasting nephropathy                                                                                                               - RTA type 1 and 2(renal tubular acidosis)
  • Vomiting,diarrhea
                                        
CLINICAL FEATURES:
  • Cramps/weakness
  • Flaccid paralysis
  • Hypercapnia: co2 narcosis

DIAGNOSIS:
  • Serum potassium (best)
  • TTKG - Trans tubular potassium gradient . if the value is >4 indicates renal wasting of potassium


  • ECG: a) T wave - lesser/absent/inverted
  • b) ST segment - depression
  • c)pseudo p - pulmonale (p wave >2.5mm)
  • d) prolongation of PR interval
  • e) prominent U wave
  • f) prolonged QU interval
COMPLICATION:

Hypo potassium ➝ arrhythmia ➝ Torsades De Pointes(polymorphic ventricular tachycardia)

TREATMENT:
  • If potassium between 3.0 - 3.5mEq/L = ORAL KCL(POTCHLOR)
  • If potassium < 3mEq/L = IV KCL (infusion)

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