A 21-year-old white man comes to the emergency dep - aiissman

[ArchivalUser]

A 21-year-old white man comes to the emergency department because of muscular weakness. He has had episodes of weakness for the past year. After coming home from the gym, he feels the inability to reach the cabinets in the kitchen. Sometimes he is unable to rise from a seated position. The attacks occur approximately 3 times per week, last 3 hours, and subside spontaneously. The attacks also occur after heavy meals. On physical examination, you note 2/5 motor strength in the bicep muscles bilaterally, with 3/5 strength of the handgrip, and 2/5 motor strength of the quadriceps bilaterally, with 4/5 strength on dorsiflexion of the feet. He has no prior medical history. Laboratory studies reveal:

Sodium 140 mEq/L; potassium 2.0 mEq/L; chloride 112 mEq/L; bicarbonate 15 mEq/L; BUN 10 mg/dL, creatinine 0.8 mg/dL.

What is the next best step in the management of this patient?

(A) Repeat potassium level
(B) Potassium chloride orally
© Acetazolamide
(D) Potassium chloride intravenously
(E) Spironolactone

[ArchivalUser]

i think it would be repeat potassium levels(a)

[ArchivalUser]

Ans D

[ArchivalUser]

Diagosis - Hypokalemic periodic paralysis [Ref - HPIM 2536]
unless the patent has DIFFICULTY in swallowing or is vomiting, Oral KCl .2 - .4 mmol/kg is sufficient. It is given every 30 minutes.

[ArchivalUser]

Severe hypokalemia (<3.0 mEq/L) may require intravenous supplementation. Typically, saline is used, with 20-40 mEq KCl per liter over 3-4 hours
so the answer is DDDDDDDDDDDDDDDD D

[ArchivalUser]

D
aissman what's d answer - oral or IV KCL

[ArchivalUser]

D is RT.

[ArchivalUser]

D) Potassium chloride intravenously