Gepost in: Metabole-Endocriene
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 (Kþ) concentration (PK). The session begins with a quiz based on six recent medical consultations for a PK5 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 dependant oedema and developed a severe degree of weakness and hypokalaemia during more aggressive diuretic therapy that included a Kþ-sparing diuretic. The initial challenge for Professor McCance was to deduce why the Kþ-sparing diuretic was not effective in this patient. He also needed to explain why the PK was so low on admission.
J.H.M. GROENEVELD, Y.W.J. SIJPKENS, S.-H. LIN, M.R. DAVIDS and M.L. HALPERIN
Q J Med 2005; 98:305–316