Lab Case 71 – Interpretation

Severe life threatening hypokalaemia in a patient with an eating disorder.

1. Describe and Interpret:

Hyperchloraemic non anion gap metabolic acidosis

HCO3 16

AG 16

CL high

Severe hypokalaemia

Rhabdomyolysis

Interpretation –

RTA with severe hypokalaemia causing Rhabdomyolysis (look for other causes of Rhabdo)

Potassium plays a major role in regulating the skeletal muscle blood flow; an increased potassium concentration in the muscle during muscle activity causes vasodilatation, which increases the regional blood flow. In state of hypokalemia, this increase is hampered causing relative ischemia in the active muscle consecutively leading to muscle cramps, and in a severely depleted state may cause muscle necrosis and rhabdomyolysis. In addition to hypoperfusion, hypokalemia-induced impairment in muscle metabolism also may contribute to muscle dysfunction.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109789/?report=printable

2. Treatment

HDU/ICU admission

ivi fluids

replace K

monitor urine output

treat pain

 

 

 

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