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Rhabdomyolysis - Differential Diagnosis Framework and Management Summary

Causes of Rhabdomyolysis:
 • Trauma:
	- Immobilization
	- Crush injury
	- Compartment
Infection - Viral (HIV ... • LDH ↑ • Hyperkalemia ... /Late - Hypercalcemia ... Dialysis for severe hyperkalemia ... #nephrology
Hyperkalemia Treatment Options
Stabilize cardiac membrane:
 • IV Calcium (peaks 5-10 minutes)
Decrease potassium concentration:
 • IV Fluids
Shift
Hyperkalemia Treatment ... membrane: • IV ... concentration: • IV ... LouLectures #Hyperkalemia ... management #potassium #nephrology
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... Suspicion for Hyperkalemia ... Drugs Causing Hyperkalemia ... cantaloupe #hyperkalemia ... potassium #high #nephrology
Hyperkalemia - Diagnosis and Management - GrepMed Handbook

S/Sx: Most pts asymptomatic. Weakness, cramping, nausea, paresthesias, palpitations,
Hyperkalemia - Diagnosis ... emcrit.org/ibcc/hyperkalemia ... management of hyperkalemia ... #Hyperkalemia ... #potassium #nephrology
Hyperkalemia - Differential Diagnosis Framework

PseudoHyperkalemia:
 • Lab error
 • Traumatic venipuncture
 • Hemolysis, thrombocytosis, leukocytosis
 •
Hyperkalemia - Differential ... Suspicion for Hyperkalemia ... Drugs Causing Hyperkalemia ... images/12834 #hyperkalemia ... potassium #high #nephrology
Causes of Hypokalemia
Transcellular Shifts:
 - Alkalosis, Increased plasma insulin (treatment of diabetic ketoacidosis), ß-Adrenergic agonists, Hypokalemic
Causes of Hypokalemia ... plasma insulin (treatment ... and lymphomas, IV ... or induced) #Hypokalemia ... differential #diagnosis #nephrology
KDIGO Treatment algorithm for management of acute hyperkalemia in the emergency department
 • Place on cardiac
KDIGO Treatment ... management of acute hyperkalemia ... Consider dialysis #hyperkalemia ... management #algorithm #treatment ... potassium #high #nephrology
Algorithm for Management of Acute and Chronic Hyperkalemia
Acute Hyperkalemia:
 - IV calcium (10 mL of 10%)
Acute and Chronic Hyperkalemia ... Acute Hyperkalemia ... binders Chronic Hyperkalemia ... optimization) #Hyperkalemia ... #nephrology
Rhabdomyolysis - Differential Diagnosis and Management Summary

Trauma:
 • Immobilization, Crush iniury, Compartment syndrome, Electrical injury
Exertional:
 •
Infection (Viral- HIV ... Dermatomyositis) AKI - Pathophysiology ... oxidative iniury Treatment ... Iinitial rate: 1 ... Dialysis for severe hyperkalemia
Gitelman Syndrome Overview

What?
• Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter
• Gitelman's syndrome
Family history of hypokalemia ... • Unexplained hypokalemia ... pressure Labs: • Hypokalemia ... Syndrome #diagnosis #nephrology ... #Hypokalemia