share email twitter ⋅ join discord whatsapp(2ck)
Free 120  NBME 24  NBME 23  NBME 22  NBME 21  NBME 20  NBME 19  NBME 18  NBME 17  NBME 16  NBME 15  NBME 13 
introducing : the “predict me” score predictor NEW!

NBME 21 Answers

nbme21/Block 1/Question#37 (21.7 difficulty score)
A 35-year-old man with diabetic ketoacidosis ...
Serum potassium concentrationπŸ”

Login to comment/vote.

Tutor box

Members from the Leaderboard offering 1-on-1 help: Want to be listed here? Email us!

submitted by nala_ula(112),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

In iatdeicb eso,csikdoait erhte si erensidac icda ni het aruaeelltrlcx aespc. rAdcgoicn ot AF etehr is a ellslnratcaur fhtis eud to esrecdeda unniisl htat adels to emro +H netegrin het lcle in xgeenahc rfo .+K ishT aesld to yeapimlhekar hwit epledtde nutlalrlreaci srsoet fo .+K reThe si saol otocsmi riduseis taht laeds to sadecienr K+ slso in teh urnei nda lttoa odby +K hTe sqeintou sksa atth si somt ylekil to saereced thwi unilins tah:yper eumrs spmiaoust attcoecnonnir lwli escrdaee sa +K is now ghenxaecd fro +H nediis eht lc.el

cienfuegos  Additional UW fun facts regarding Potassium and DKA: use caution giving insulin and IV fluids to dehydrated hyperglycemic because i forces K in cells causing fast decrease of extracellular Potassium, thus give K supplementation even when serum K elevated +3  
linwanrun1357  Why urine K+ does not decrease? +3  

This explanation is faulty. Insulin causes K to go inside via upregulating NaKATPase activity. Nothing to with H+ exchange as far as Insulin is concerned.

H and K exchange is separate from this.

+12/- b1ackcoffee(46),

submitted by an_improved_me(13),


Insulin does play a role in bringing back K+ into cells via modulation of K+/H+ exchange. This is because it helps to address the ketoacidotic state of the patient. By bringing pH closer to baseline, there is return of K+ into the cells, while H+ comes back out of the cells.

an_improved_me  However, you are right, in that too my knowledge, that is not the main way insulin influences K+; it is more via the NaATPase as you have mentioned. +