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An approach to the patient with severe hypokalaemia: the potassium quiz Groeneveld JH; Sijpkens YW; Lin SH; Davids MR; Halperin MLQJM 2005[Apr]; 98 (4): 305-16The objective of this teaching session with Professor McCance is to develop an approach to the management of patients with a very low plasma potassium (K(+)) concentration (P(K)). The session begins with a quiz based on six recent medical consultations for a P(K) < 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 dependent oedema and developed a severe degree of weakness and hypokalaemia during more aggressive diuretic therapy that included a K(+)-sparing diuretic. The initial challenge for Professor McCance was to deduce why the K(+)-sparing diuretic was not effective in this patient. He also needed to explain why the P(K) was so low on admission.|Acidosis/complications/metabolism[MESH]|Adult[MESH]|Aged[MESH]|Alkalosis/complications/metabolism[MESH]|Cell Physiological Phenomena[MESH]|Creatinine/metabolism[MESH]|Diuretics/therapeutic use[MESH]|Female[MESH]|Humans[MESH]|Hypokalemia/drug therapy/*physiopathology/urine[MESH]|Kidney/physiopathology[MESH]|Male[MESH]|Middle Aged[MESH]|Paralysis/physiopathology[MESH]|Potassium/metabolism[MESH]|Sodium Bicarbonate/metabolism[MESH] |
