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nbme24/Block 2/Question#26 (58.6 difficulty score)
A 35-year-old man is brought to the emergency ...
Catecholamine-mediated intracellular shifts of K+πŸ”
tags: alcohol electrolytes 

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submitted by poormedstudent(12),
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I wsa tyrign ot fegriu uto ohw ear het saeotclimnheac scuea the K hitsf noit eht ce.lls I was otn gsieen eht ceononcnit ta fmnlytao l.isrr in old MsBNE and rwdoUl iqse-snotu nnsIiul is uignsca +K to nteer eht .lcesl n the I emembrer enegis the tkshcye dnab cmpa dan ni eht far trihg of teh thseck ereht si 2B tcitanvoai = abet 2 autb or .seoinmhg.t awt anyebya 2 is unofd no cipraaenct ateb ncm,clsolhcait alsaee tvaeacit btae 2 no aapcnrecit teab elslc hwich lilw cusea nliuins ot eb nliuins edlreesa seuasc K ot be edvirn siinde hte elslc, uncgasi het hlkmiyopaae


-AF 0921 gp 832 Btae 2 t-&;-g rcesaein in usiniln eareles nad rinacees aclreull +K .upkate

iad-nL S. szntoaC'so phoyoygsil e:tmaigtex wghsino nnlusii dan beat goisant ngrivdi K+ iont teh clsel

cassdawg  FA2020 p590 lists all the stuff that causes different potassium shifts +1  
syoung07  This is correct but a lot going on. Catecholamines directly stimulate Na/K atpase just like insulin does. +1  

submitted by rolubui(13),
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1) locAolh dlarawtwih >-;- zuesrie

2) zeSreui -g-&;t csaiernde eearels fo easomctnleahci (d56t.g3.uhinp2wo//ecsp.4bvmbh//tinmn.w0wl:8), asol BP of 1100/80 dasntciie ihhg levesl of csoeatlhcaenmi

3) rMaoj nmoseroh that sifht +K tlllirycaeulnra are nulniis m&pa; edgrniatarb-ce2e- ssiotnga g.e(. eipepnnhrie (nan1ne/iielea0/tnh.d/u6ic8/0hgc.wgcliup.wmickopdl/i.ut1ftsgis7p.:w2s)

4) Also ythe are knaisg hyw rsuem +K is wlo, TNO hyw uenir K+ is hhgi

osler_weber_rendu  Point 4) above helps you RULE OUT MUSCLE BREAKDOWN. It will cause initial hyperkalemia. Hypokalemia, if at all happens weeks later in ATN. +3  
hungrybox  Thanks for explaining why it's not muscle breakdown. Was stuck on that one. +  

submitted by paszw0red(13),
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eecEnidmi y:sas erilmiuD tmsenre DsT)( is eht stom eevres mrof of lhnoeat ,twdiaarwlh miednaetsf yb lredtea aletnm attsus gllabo( nfso)niuco adn samicphttye oridevrve (ioacunomt ttapr)yvieiych, hiwhc nca goessrpr to racoudilasrvac eal.oplsc

oAsl iio/st.ans/b5uc0patnivati/monaa.hbshu/

I esusam het atptnei sha meruleDi emsr,nte dah a euzsier, nad onw is thneyrivpsee seceuab of hte pcehtiyat"s iveoe,r"drv ihtw cxeses ionertecs fo snhlciaoec,meta uhts the hle.myokpaia

submitted by medstruggle(12),
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nCa eemoons xlaepni hyw deos htsi tniaept aevh miakeplhayo?

colonelred_  Catecholamines activate the Na/K pump, which will drive K inside. +11  
trazabone  Read online that catachelamines are released following tonic clonic seizures. Besides that, BP of 180/100 could indicate that catecholamines are circulating. +1  
fulminant_life  This mechanism is why giving albuterol for hyperkalemia works +9  
nbmehelp  Why does this guy have increased catecholamines tho +  
johnson  His SNS activity is seriously increased --> increased catecholamines. +  
nbmehelp  Why is his SNS activity increased? Is the BP literally the only hint? +  
youssefa  Alcohol withdrawal creates a hyper- catecholaminergic state + Seizures do that as well. +5  
water  My best guess is that withdrawal puts the body in a state of stress (same for seizures) and with stress you have release of catecholamine which we'll see in the BP and the hypokalemia. +3  

submitted by fallot4logy(10),
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ni het hetro ndah , nruei iussapotm si high nhuego , os fi esuzersi ohtgism&;aor=slydby &tg=; nmuooabgiiyrl t;g&= ANT gt=&; high stopsmuai coxrintee , ywh t?on

krewfoo99  True but hypokalemia would occur in the recovery phase. So weeks after the inciting phase. +1  
therealslimshady  Acute rhabdomyolysis would lead to hyperkalemia, not hypokalemia, because cells are packed with K+ +  

submitted by fleurmuxlin(1),
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ishT bymae to tela fro annyeo btu hree aws ym itarn of thuthog theamilnC coea .:1 aeerisnsc inulisn sereale g;&--t ulg dan K llwi enrte csl.le sgiCuna kpmyleiahoa in hte slpmaa 2 . aCn reriggt het beat 1 teporerc ncsagui teh lsearee of -R--negtn&;i goitnnnseiA 2 nca( eb rbtiuocintng / gancusi na ercseain ni --&);BPtg ardltsooeen &--;gt yuo setwa K in eth .nruei