Hypokalemia clinical presentation

Appropriate follow-up care of patients with acute diarrhea is based on successful restoration of fluid losses. The clinical signs and symptoms (see Table 111-1) that led to the diagnosis also can indicate adequate rehydration and should be assessed frequently. Because oral rehydration therapy is now preferred, routine laboratory testing often is unnecessary. Electrolytes should be measured in those receiving parenteral fluids, when oral replacement fails, or when signs of hypernatremia or hypokalemia are present. Follow-up stool samples to ensure complete evacuation of the infecting pathogen may be necessary only... 

III. Clinical presentation. Within minutes to a few hours after ingestion, victims develop profound hypokalemia and skeletal muscle weakness progressing to flaccid paralysis of the limbs and respiratory muscles. Ventricular arrhythmias, hypophosphatemia, rhabdomyolysis, acute renal failure, and coagulopathy may also occur. Gastroenteritis with severe watery diarrhea, mydriasis with impaired visual accommodation, and CNS depression are sometimes present. More often, patients remain conscious even when severely Intoxicated. 

II. Toxic dose. Inhalation or ingestion of as little as 1 mg of fluoroacetate is sufficient to cause serious toxicity. Death is likely after ingestion of mote than 5 mg/kg. Clinical presentation. After a delay of minutes to several hours (in one report coma was delayed 36 hours), manifestations of diffuse cellular poisoning become apparent nausea, vomiting, diarrhea, metabolic acidosis, renal failure, agitation, confusion, seizures, coma, respiratory arrest, pulmonary edema, and ventricular arrhythmias may occur. One case series reported a high incidence of hypocalcemia and hypokalemia. 

The clinical presentation of patients with endocrine pancreatic tumors will vary according to the type of hormone released. Hyperinsulinism manifested with diarrhea, abdominal pain, and low levels of glucose will be found in the majority of patients. Nesidioblastosis is a primitive pancreatic B cells hyperplasia. Approximately 5% of patients with hyperinsulinism may have this type of tumor. Hunger, jitteriness, lethargy, apnea, and seizures are common manifestations in newborns with nesidioblastosis, while older children may show diaphoresis, confusion, or unusual behavior. Zollinger-Elli-son syndrome will present with intractable peptic ulcers. Patients with vipomas will have watery diarrhea, hypokalemia, and achlorhydria, while multiple endocrine neoplasias have been reported with multiple endocrine neoplasia type 1 (MEN 1). 

Hypokalemia is the key clinical finding that primary aldosteronism may be present in a patient with diastolic hypertension. To confirm the diagnosis, it is necessary to... 

The clinical manifestations of hypocalcemia are quite variable. The acuteness of the development of hypocalcemia plays a large role in whether or not symptoms will occur." The more acute the drop in ionized calcium concentration, the more likely the patient will develop symptoms. Thus acid-base balance plays a significant role in the hkeiihood of the development of hypocalcemic symptoms, with alkalosis predisposing to symptom development. Concomitant hypomagnesemia, hypokalemia, hyponatremia, and additive side effects from prescribed medications also increase the likelihood of symptomatic presentation. 

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