An approach to the patient with severe hypokalaemia: the potassium quiz.
The objective of this teaching session with Professor McCance is to develop an approach to the management of patients with a very low plasma potassium (K(+)) concentration (P(K)). The session begins with a quiz based on six recent medical consultations for a P(K) < 2 mmol/l. Professor McCance outlined how he would proceed with his diagnosis and therapy, using the synopsis that described each patient. This approach was then applied to a new patient, a 69-year-old woman who had a large volume of dependent oedema and developed a severe degree of weakness and hypokalaemia during more aggressive diuretic therapy that included a K(+)-sparing diuretic. The initial challenge for Professor McCance was to deduce why the K(+)-sparing diuretic was not effective in this patient. He also needed to explain why the P(K) was so low on admission.
Groeneveld
J H M
JH
Department of Nephrology, Leiden University Medical Center, The Netherlands.
Sijpkens
Y W J
YW
Lin
S-H
SH
Davids
M R
MR
Halperin
M L
ML
D000138:Acidosis / Q000150:complications / Q000378:metabolism; D000328:Adult; D000368:Aged; D000471:Alkalosis / Q000150:complications / Q000378:metabolism; D002468:Cell Physiological Phenomena; D003404:Creatinine / Q000378:metabolism; D004232:Diuretics / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007008:Hypokalemia / Q000188:drug therapy / Q000503:physiopathology* / Q000652:urine; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010243:Paralysis / Q000503:physiopathology; D011188:Potassium / Q000378:metabolism; D017693:Sodium Bicarbonate / Q000378:metabolism
D004232:Diuretics; D017693:Sodium Bicarbonate; D003404:Creatinine; D011188:Potassium