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Questions and Answers
What is the daily adequate intake of potassium recommended for Canadians?
What is the daily adequate intake of potassium recommended for Canadians?
- 6000 mg
- 5000 mg
- 3500 mg
- 4700 mg (correct)
Hypomagnesemia is characterized by an excess of magnesium in the body.
Hypomagnesemia is characterized by an excess of magnesium in the body.
False (B)
What are the two main types of potassium imbalances?
What are the two main types of potassium imbalances?
Hypokalemia and Hyperkalemia
Potassium is the most abundant __________ cation in the body.
Potassium is the most abundant __________ cation in the body.
Which foods are high in potassium?
Which foods are high in potassium?
Match the type of magnesium imbalance with its respective condition:
Match the type of magnesium imbalance with its respective condition:
98% of total body potassium is located within cells.
98% of total body potassium is located within cells.
What is the role of the Na+-K+-ATPase pump in potassium transport?
What is the role of the Na+-K+-ATPase pump in potassium transport?
Which of the following is a major determinant of the resting action potential in neurons and muscle cells?
Which of the following is a major determinant of the resting action potential in neurons and muscle cells?
Most Canadians do not reach the recommended potassium intake due to __________ in their diet.
Most Canadians do not reach the recommended potassium intake due to __________ in their diet.
What is the normal range for serum potassium concentration?
What is the normal range for serum potassium concentration?
Excretion from the kidneys accounts for 90% of potassium loss in the body.
Excretion from the kidneys accounts for 90% of potassium loss in the body.
What are two factors that affect serum potassium concentration?
What are two factors that affect serum potassium concentration?
Hypokalemia occurs when serum potassium levels fall below _____ mmol/L.
Hypokalemia occurs when serum potassium levels fall below _____ mmol/L.
Which of the following is a symptom of hypokalemia?
Which of the following is a symptom of hypokalemia?
Name one hormone that affects serum potassium concentration.
Name one hormone that affects serum potassium concentration.
Match the following potassium disorders with their definitions:
Match the following potassium disorders with their definitions:
Sequestration in muscle and hepatic cells has no impact on serum potassium levels.
Sequestration in muscle and hepatic cells has no impact on serum potassium levels.
Potassium represents about _____ % of total body potassium.
Potassium represents about _____ % of total body potassium.
Which system accounts for the minor percentage of potassium excretion?
Which system accounts for the minor percentage of potassium excretion?
What can lead to hyperkalemia due to increased potassium intake?
What can lead to hyperkalemia due to increased potassium intake?
Adrenal insufficiency can cause decreased potassium excretion.
Adrenal insufficiency can cause decreased potassium excretion.
Name a drug class that can induce hyperkalemia.
Name a drug class that can induce hyperkalemia.
The redistribution of potassium into extracellular space can be caused by _____ acidosis.
The redistribution of potassium into extracellular space can be caused by _____ acidosis.
Match the following drugs with their potential effect on potassium levels:
Match the following drugs with their potential effect on potassium levels:
Which of the following is a goal of therapy in managing hyperkalemia?
Which of the following is a goal of therapy in managing hyperkalemia?
Symptomatic patients generally require conservative management of hyperkalemia.
Symptomatic patients generally require conservative management of hyperkalemia.
What is administered to raise the cardiac threshold potential in cases of hyperkalemia?
What is administered to raise the cardiac threshold potential in cases of hyperkalemia?
Drug-induced hyperkalemia can be caused by _____ antagonists.
Drug-induced hyperkalemia can be caused by _____ antagonists.
Match the following electrolyte imbalances with their types:
Match the following electrolyte imbalances with their types:
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Study Notes
Potassium
- Daily potassium intake of 4700mg is recommended
- Most people do not reach this amount
- Potassium rich foods: fruits, vegetables, potatoes, milk, yogurt, bran cereals
- 98% of potassium is located in cells
- Actively transported into cells via the Na+-K+-ATPase pump
- Potassium is the most abundant intracellular cation
- Potassium is a major determinant of the resting action potential in neurons, skeletal muscles, and cardiac myocytes
- Normal serum potassium concentration is 3.5-5.0 mmol/L (mEq/L)
- Serum potassium concentration is affected by dietary intake, excretion, sequestration in muscles and hepatic cells, hormone levels, and acid-base balance
Hypokalemia
- Hypokalemia occurs when serum potassium <3.5 mmol/L
Hyperkalemia
- Hyperkalemia occurs when serum potassium > 5.0 mmol/L
- Causes include increased intake, decreased excretion, and redistribution of potassium into the extracellular space
- Drug-induced hyperkalemia can be caused by ACE inhibitors, ARBs, direct renin inhibitors, MRAs, potassium-sparing diuretics, NSAIDs, 𝛽-blockers, digoxin, cyclosporine, tracolimus, and trimethoprim/sulfamethoxazole
Management of Hyperkalemia
- Evaluate the severity of hyperkalemia, the rate of onset, and the patient's clinical condition
- Identify any diet or drug related contributions to elevated potassium levels
- Minimize cardiac conduction effects by administering intravenous calcium
- Return serum and total body stores of potassium to normal levels
Management of Mild to Moderate Hyperkalemia
- Asymptomatic patients with [K+] 5.0–5.5 mmol/L can be managed with dietary potassium restriction
- Asymptomatic patients with [K+] 5.5–6.0 mmol/L can be managed with dietary potassium restriction and oral potassium-binding resins (e.g., sodium polystyrene sulfonate (Kayexalate) )
- Oral potassium-binding resins should not be used in patients with bowel obstruction
- Oral potassium-binding resins should be used with caution in patients with hypomagnesemia
Management of Severe Hyperkalemia
- Patients with [K+] >6.0 mmol/L and/or ECG abnormalities require immediate treatment with intravenous calcium gluconate and insulin/glucose
- Severe hyperkalemia is a medical emergency
Magnesium
- Magnesium is the second most abundant intracellular cation
- Magnesium is critical for normal cell function
- Magnesium is involved in more than 300 enzymatic reactions
- Normal serum magnesium concentration is 0.65-1.05 mmol/L
Hypomagnesemia
- Hypomagnesemia occurs when serum magnesium is < 0.65 mmol/L
- Hypomagnesemia is often associated with hypokalemia and hypocalcemia
- Hypomagnesemia can be caused by decreased intake, increased excretion, or redistribution of magnesium from the extracellular space
Hypermagnesemia
- Hypermagnesemia occurs when serum magnesium >1.05 mmol/L
- Hypermagnesemia is uncommon and is most often caused by renal failure
- Hypermagnesemia can also be caused by excessive magnesium intake (e.g., magnesium sulfate)
Management of Hypomagnesemia
- Management of Hypomagnesemia is dependent upon the severity
- Oral magnesium supplementation is typically used for mild hypomagnesemia
- Intravenous magnesium is used for moderate to severe hypomagnesemia
Management of Hypermagnesemia
- Management of Hypermagnesemia is dependent upon the severity
- Mild Hypermagnesemia can be managed with discontinuation of magnesium-containing medications
- Moderate to Severe Hypermagnesemia may require dialysis
- Calcium gluconate can be used to antagonize the cardiac effects of hypermagnesemia
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