A 34-year-old man with type 1 diabetes presents with Kussmaul respirations, confusion, and fruity breath. Vital signs show BP 102/68, HR 118, RR 24, temp 37.2°C. Labs reveal glucose 456 mg/dL, pH 7.18, HCO3- 12 mEq/L, K+ 5.8 mEq/L, anion gap 18, and elevated beta-hydroxybutyrate. Urine ketones are present; troponin is normal. Which mechanism best explains the pseudohypokalemia in this patient?
- A)Insulin deficiency impairs Na-K-ATPase function and potassium uptake
- B)Osmotic diuresis causes selective urinary potassium wasting
- C)Hypertonicity causes water and potassium shift from intracellular to extracellular spaceGABARITO
- D)Glucagon excess stimulates renal potassium secretion
- E)Metabolic acidosis directly increases serum potassium via H+ and K+ exchange
Explicação
DKA presents with pseudohyperkalemia (not pseudohypokalemia; term correction: apparent hyperkalemia despite total body K+ depletion). Hyperglycemia creates osmotic gradient pulling water and K+ extracellularly. Despite high serum K+, total body K+ is severely ... Ver explicação completa e trilha adaptativa →