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diagnosis differential algorithm management hyperkalemia hypokalemia metabolic low treatment workup alkalosis hyponatremia kidney acidosis blood clinical microscopy pathophysiology syndrome urology
Causes of Hyperkalemia Hyperkalemia is caused by excess potassium intake, impaired potassium excretion, or transcellular shifts. The
Causes of Hyperkalemia ... by excess potassium ... transcellular shifts ... with impaired renal ... and underlying renal
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 Hypokalemia - Differential Diagnosis Algorithm Transcellular Shift: • Alkalosis • ↑ beta-2 adrenergic simulation • Erythropoiesis
Transcellular Shift ... Medications Renal ... Losses Non-renal ... Diagnosis #Algorithm #nephrology ... #low #potassium
Causes of Hyperkalemia - Differential Diagnosis Algorithm • Increased Intake • Reduced Excretion (IV potassium with
Causes of Hyperkalemia ... Excretion (IV potassium ... Transcellular Shift ... #Hyperkalemia #Nephrology ... Diagnosis #Algorithm #Causes
Approach to Hypomagnesemia Fractional excretion of magnesium = (urine magnesium x serum creatinine)/ [0.7 (serum magnesium
of magnesium = (urine ... serum magnesium x urine ... intake, Gl loss, shift ... differential #diagnosis #causes ... #nephrology #magnesium
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 ... creatinine) • Cell shift ... mmol creatinine) High ... #potassium #differential ... algorithm #diagnosis #nephrology
Hyperkalemia: Diagnostic algorithm Decreased renal potassium excretion • Acute renal failure • Chronic renal failure • Drugs Increased
potassium excretion ... • Acute renal ... Normal, Renin High ... hypoplasia Aldosterone high ... Diagnosis #algorithm #nephrology
Hyperkalemia Treatment Options Stabilize cardiac membrane: • IV Calcium (peaks 5-10 minutes) Decrease potassium concentration: • IV Fluids Shift
minutes) Decrease potassium ... • IV Fluids Shift ... potassium intracellularly ... (if preserved renal ... #nephrology
Hypokalemia Evaluation Algorithm Before evaluating hypokalemia, life threatening complications such as arrhythmias and paralysis should be looked
A urine K/Cr ratio ... suggests extra-renal ... causes • Laxative ... urinary losses: • High ... #nephrology #low
Hyperkalemia - Differential Diagnosis Framework PseudoHyperkalemia: • Lab error • Traumatic venipuncture • Hemolysis, thrombocytosis, leukocytosis •
phlebotomy High ... Intracellular Shift ... differential #diagnosis #causes ... #potassium #high ... #nephrology
Atlas of Urine Microscopy Findings • Epithelial cells - Normal • Renal tubular cells - Acute
Atlas of Urine Microscopy ... also be seen if urine ... - Up to 3 per high-power ... normal; >3 per high-power ... key #diagnosis #nephrology
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