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Questions and Answers
What does an increase in B12 lead to concerning Nat/17 ATPase insulin?
What does an increase in B12 lead to concerning Nat/17 ATPase insulin?
Megaloblastic anaemia does not require further supplementation.
Megaloblastic anaemia does not require further supplementation.
False
What condition is associated with M.acidosis in this context?
What condition is associated with M.acidosis in this context?
Diarrhoea
In cases of diarrhoea, laxatives containing __________ may contribute to metabolic acidosis.
In cases of diarrhoea, laxatives containing __________ may contribute to metabolic acidosis.
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Match the following conditions with their associated symptoms:
Match the following conditions with their associated symptoms:
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What is a common clinical feature of hypokalaemia?
What is a common clinical feature of hypokalaemia?
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Hyperkalaemia always presents with severe symptoms.
Hyperkalaemia always presents with severe symptoms.
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What is the potassium level defining hypokalaemia?
What is the potassium level defining hypokalaemia?
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Insulin increases the activity of the _____ ATPase, leading to potassium shifts.
Insulin increases the activity of the _____ ATPase, leading to potassium shifts.
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Match the condition with its cause:
Match the condition with its cause:
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What is a clinical feature of hyperkalaemia?
What is a clinical feature of hyperkalaemia?
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Urine potassium levels below 20 indicate renal loss.
Urine potassium levels below 20 indicate renal loss.
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What is the primary risk associated with hypokalaemia?
What is the primary risk associated with hypokalaemia?
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In hyperkalaemia, ECG abnormalities can progressively show abnormalities in _____ readings.
In hyperkalaemia, ECG abnormalities can progressively show abnormalities in _____ readings.
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Which drug is indicated for asthma and can contribute to hypokalaemia?
Which drug is indicated for asthma and can contribute to hypokalaemia?
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What are the minimum UOSm and U[Na] values for CCT to be valid?
What are the minimum UOSm and U[Na] values for CCT to be valid?
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Pseudohyperkalaemia can occur due to ex-vivo release from cells.
Pseudohyperkalaemia can occur due to ex-vivo release from cells.
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What condition is related to a massive lysis of a high burden tumor?
What condition is related to a massive lysis of a high burden tumor?
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The condition where plasma K is greater than serum K is known as ________ pseudohyperkalaemia.
The condition where plasma K is greater than serum K is known as ________ pseudohyperkalaemia.
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Match each type of sample collection with its potential effect on potassium levels:
Match each type of sample collection with its potential effect on potassium levels:
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Which of the following could lead to Pseudohyperkalaemia?
Which of the following could lead to Pseudohyperkalaemia?
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Chemotherapy and radiation therapy can contribute to the development of tumor lysis syndrome.
Chemotherapy and radiation therapy can contribute to the development of tumor lysis syndrome.
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In which disease are neoplastic WBC membranes sensitive to heparin, leading to reverse pseudohyperkalaemia?
In which disease are neoplastic WBC membranes sensitive to heparin, leading to reverse pseudohyperkalaemia?
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Which condition is associated with loss of gastric acid?
Which condition is associated with loss of gastric acid?
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Diuretics can cause potassium retention.
Diuretics can cause potassium retention.
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What does RTA stand for in metabolic disorders?
What does RTA stand for in metabolic disorders?
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Vomiting leads to loss of ______, contributing to metabolic alkalosis.
Vomiting leads to loss of ______, contributing to metabolic alkalosis.
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Match the following disorders with their main cause:
Match the following disorders with their main cause:
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Which statement is true regarding saline-resistant metabolic alkalosis?
Which statement is true regarding saline-resistant metabolic alkalosis?
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Cisplatin is known for its nephrotoxic effects.
Cisplatin is known for its nephrotoxic effects.
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What role does aldosterone play in acid-base balance?
What role does aldosterone play in acid-base balance?
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In metabolic acidosis, the concentration of H+ ions is ______.
In metabolic acidosis, the concentration of H+ ions is ______.
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Match the following drugs with their effects on the renal system:
Match the following drugs with their effects on the renal system:
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What effect does volume contraction have on the renal system?
What effect does volume contraction have on the renal system?
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Loss of sodium and chloride can occur due to diarrhea.
Loss of sodium and chloride can occur due to diarrhea.
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What is the typical urine chloride level in saline-responsive metabolic alkalosis?
What is the typical urine chloride level in saline-responsive metabolic alkalosis?
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Conn's Syndrome is characterized by hyperaldosteronism leading to ______ hypertension.
Conn's Syndrome is characterized by hyperaldosteronism leading to ______ hypertension.
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Which condition is characterized by increased renin and aldosterone levels due to a tumor?
Which condition is characterized by increased renin and aldosterone levels due to a tumor?
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Hypomagnesemia can lead to renal excretion of potassium.
Hypomagnesemia can lead to renal excretion of potassium.
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What is a common treatment for thyrotoxic periodic paralysis?
What is a common treatment for thyrotoxic periodic paralysis?
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A genetic disorder leading to low renin and high aldosterone is known as __________ syndrome.
A genetic disorder leading to low renin and high aldosterone is known as __________ syndrome.
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Match the following causes with their corresponding effects or conditions:
Match the following causes with their corresponding effects or conditions:
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Which treatment is NOT recommended for thyrotoxic periodic paralysis?
Which treatment is NOT recommended for thyrotoxic periodic paralysis?
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Thyrotoxic periodic paralysis is characterized by positivity after prolonged rest.
Thyrotoxic periodic paralysis is characterized by positivity after prolonged rest.
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What should be corrected before addressing hypokalemia in patients with hypomagnesemia?
What should be corrected before addressing hypokalemia in patients with hypomagnesemia?
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__________ syndrome is a genetic disorder associated with low renin and elevated aldosterone levels.
__________ syndrome is a genetic disorder associated with low renin and elevated aldosterone levels.
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Which of the following is a common presentation of thyrotoxic periodic paralysis?
Which of the following is a common presentation of thyrotoxic periodic paralysis?
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Licorice consumption can lead to increased levels of cortisol due to 11β-HSD deficiency.
Licorice consumption can lead to increased levels of cortisol due to 11β-HSD deficiency.
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What is a key monitoring consideration for patients treated for thyrotoxic periodic paralysis?
What is a key monitoring consideration for patients treated for thyrotoxic periodic paralysis?
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In hyperaldosteronism, the renin levels are _____ due to negative feedback.
In hyperaldosteronism, the renin levels are _____ due to negative feedback.
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Match the following conditions with their treatments:
Match the following conditions with their treatments:
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Which electrolyte imbalance is characterized by the rapid breakdown of skeletal muscle cells?
Which electrolyte imbalance is characterized by the rapid breakdown of skeletal muscle cells?
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Rhabdomyolysis causes an increase in muscle enzymes such as CK and AST.
Rhabdomyolysis causes an increase in muscle enzymes such as CK and AST.
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Name one of the treatments for laboratory TLS.
Name one of the treatments for laboratory TLS.
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In Gitelman syndrome, the defect is in the __________ transporter at the DCT.
In Gitelman syndrome, the defect is in the __________ transporter at the DCT.
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Match the genetic channelopathy with its associated electrolyte imbalance:
Match the genetic channelopathy with its associated electrolyte imbalance:
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Which of the following is NOT a clinical feature of TLS?
Which of the following is NOT a clinical feature of TLS?
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Hypocalcemia is a feature of both TLS and rhabdomyolysis.
Hypocalcemia is a feature of both TLS and rhabdomyolysis.
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What is one cause of Hyperphosphatemia in laboratory TLS?
What is one cause of Hyperphosphatemia in laboratory TLS?
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Forced alkaline diuresis for rhabdomyolysis can be achieved by adding __________ to urine.
Forced alkaline diuresis for rhabdomyolysis can be achieved by adding __________ to urine.
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Match the treatment with the condition it addresses:
Match the treatment with the condition it addresses:
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What is the primary cause of hyperkalemia in rhabdomyolysis?
What is the primary cause of hyperkalemia in rhabdomyolysis?
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Bartter syndrome is characterized by metabolic acidosis.
Bartter syndrome is characterized by metabolic acidosis.
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What is one clinical manifestation of myoglobinuria?
What is one clinical manifestation of myoglobinuria?
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Metabolic alkalosis and __________ are features of Liddle syndrome.
Metabolic alkalosis and __________ are features of Liddle syndrome.
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Study Notes
CPY-L7 Potassium Disorders
- Clinical Features - Hypokalaemia: Asymptomatic when mild, muscle weakness, increased risk of arrhythmia, progressive ECG abnormalities.
- **Clinical Features - Hyperkalaemia:**Asymptomatic when mild, muscle weakness, paralysis, progressive ECG abnormalities.
-
Approach to Hypokalaemia:
- Transcellular shift: Insulin, adrenergic response, theophylline, thyrotoxic periodic paralysis (TH), anabolic surge.
- Renal Loss: Urine K+ > 40 mEq/L, metabolic alkalosis, saline resistant (U[Cl] > 20), extrarenal loss (e.g., vomiting, diarrhea), metabolic acidosis.
- Approach to Hyperkalaemia: True deficit, urine K < 20, saline responsive (U[Cl]<10).
-
Specific Diseases:
- Thyrotoxic Periodic Paralysis: Common in Chinese young males, transient paralysis after heavy meals/exercise, treatment includes K supplementation, propranolol, anti-thyroid treatment, monitor K levels/respiratory involvement.
- Hypomagnesemia: Corrected Mg before correcting K, increased renal K excretion, reduced PTH secretion/action.
-
Specific Diseases (cont'd):
- Vomiting: Loss of gastric H+, Cl-, K+ (sodium solution can correct volume contraction, but not K+ imbalance)
- Diuretics: Thiazides (hypocalcemia), loop diuretics (hypocalcemia/hypomagnesemia), potassium-sparing diuretics (hyperkalemia)
Potassium Imbalances
- Hyperkalaemia: Potassium level > 5.0 mEq/L; causes include massive cell lysis, insulinopenia, drugs (e.g., ACEIs, NSAIDs, potassium-sparing diuretics), decreased renal function.
- Pseudohyperkalaemia: Falsely elevated potassium levels due to factors like ex-vivo release, contamination, thrombocytosis, leucocytosis; validated by criteria (Uosm >300 mOsm/L and U[Na]> 25 mEq/L).
- Trans-tubular Potassium Gradient (TTKG): Used to assess renal handling of potassium, surrogate for mineralocorticoid activity; calculated using urine and plasma potassium and osmolality.
- Tumour Lysis Syndrome (TLS): Massive lysis of high-burden tumors; laboratory indicators include hyperuricemia, hyperphosphatemia, hypocalcemia; clinical TLS = lab TLS + ↑Cr/seizure/arrhythmia/sudden death.
- Rhabdomyolysis: Rapid skeletal muscle lysis; features include increased K, phosphate, urate, decreased calcium, myoglobinuria; treatment focuses on hydration, electrolyte correction, forced alkaline diuresis.
Genetic Channelopathies
- Specific genetic defects in ion transport channels (e.g., Bartter, Gitelman, Gordon, Liddle, PHA I and II).
- Specific associated with metabolic acidosis or alkalosis and affecting various potassium levels.
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Description
Explore the clinical features and management strategies for hypokalaemia and hyperkalaemia in this quiz. Understand the specific diseases associated with potassium disorders and their implications. Test your knowledge of how to approach these conditions in clinical practice.
