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There are similarities and differences between these 3 conditions which all carry treatment implications. Each mimic
which all carry treatment ... easily outweighs Insulin ... for Refeeding Syndrome ... provided the starting potassium ... algorithm #management #treatment
Hyperkalemia Management
Membrane Stabilizers:
 • Calcium gluconate
Shifters:
 • Insulin + glucose
 • Albuterol
Excreters:
 • Furosemide
 • Sodium
gluconate Shifters: • Insulin ... Hyperkalemia #Management #Treatment ... #Potassium
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... minutes) Decrease potassium ... Fluids Shift potassium ... intracellularly: • Insulin ... Sodium bicarbonate Potassium
Causes of Hypokalemia - Differential Diagnosis Algorithm
Increased Loss 
 - Increased GI Loss
 - Increased Urinary
K+ into cells: Insulin ... - Refeeding Syndrome ... Algorithm #causes #potassium
Hypoglycemia Workup and Differential Diagnosis
Workup:
 • Sulfonylurea Labs
 • Anti-lnsulin Ab - Insulin Autoimmune Syndrome
 •
Ab - Insulin Autoimmune ... Syndrome • IGF ... Serum glucose, Insulin ... Misuse • Insulin ... Autoimmune Syndrome
Causes of Metabolic Alkalosis - Differential Diagnosis
Chloride depletion syndromes
 • Gastrointestinal losses
    -
Chloride depletion syndromes ... - Gitelman syndrome ... • Liddle syndrome ... • Severe potassium ... depletion (serum potassium
Pathophysiology of Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar Syndrome (HHS)
Absolute Insulin deficit:
 - Type I DM:
Hyperglycemic Hyperosmolar Syndrome ... HHS) Absolute Insulin ... Type I DM: No insulin ... stresses that ↑ insulin ... TX, stresses ↑ Insulin
Emergent Hyperkalemia Treatment Algorithm
ECG changes, weakness, K+ >6.5 Or renal insufficiency with K >5.5 with cellular
Emergent Hyperkalemia Treatment ... cells - Combo of insulin ... reduction • Insulin ... units regular insulin ... Remove potassium
Algorithm for patients with hypokalemia on the basis of the potassium-to-creatinine ratio in the urine
Urine K+
the basis of the potassium-to-creatinine ... Administration of inulin ... excess, Liddle syndrome ... , Gitelman syndrome ... hypokalemia #urine #potassium
Hyperkalemia - Management Algorithm
 • IV calcium
 • IV insulin and glucose and/or salbutamolt
 • Consider
calcium • IV insulin ... Dialysis Serum potassium ... #hyperkalemia #potassium ... management #algorithm #treatment