Overview of diagnostic approach to hypokalemia: hypokalemia without total body potassium depletion. Hypokalemia can result from transcellular shifts of potassium into cells without total body potassium depletion or from decreases in total body potassium. Perhaps the most dramatic examples occur in catecholamine excess states, as after administration of l^adreneric receptor (P2AR) agonists or during "stress." It is important to note that, during some conditions (eg, ketoacidosis), transcellular shifts and potassium depletion exist simultaneously. Spurious hypokalemia results when blood specimens from leukemia patients are allowed to stand at room temperature; this results in leukocyte uptake of potassium from serum and artifactual hypokalemia. Patients with spurious hypokalemia do not have clinical manifestations of hypo-kalemia, as their in vivo serum potassium values are normal. Theophylline poisoning prevents cAMP breakdown (see Fig. 3-3). Barium poisoning from the ingestion of soluble barium salts results in severe hypokalemia by blocking channels for exit of potassium from cells. Episodes of hypokalemic periodic paralysis can be precipitated by rest after exercise, carbohydrate meal, stress, or administration of insulin. Hypokalemic periodic paralysis can be inherited as an autosomal-dominant disease or acquired by patients with thyrotoxicosis, especially Chinese males. Therapy of megaloblastic anemia is associated with potassium uptake by newly formed cells, which is occasionally of sufficient magnitude to cause hypokalemia [13].

Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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