K+ imbalance in diabetic ketoacidosis

[petriem1]

I have a question in a diabetes worksheet we have been given to do for our pharmacology class:

Number in sequence from 1 to 8 the processes of potassium imbalance in diabetic ketoacidosis (DKA)

___a. Treatment with insulin increases glucose metabolism and decreases fat metabolism

___b. Decreases H+ ions in the blood

___c. K+ from the cells moves into blood in exchange for H+ ions.

___d. Movement of K+ back into cells.

___e. K+ excreted in urine with osmotic diuresis.

___f. Increased serum K+ concentration.

___g. Totsl body K+ deficit.

___h. Increased H+ ions present in form of acidic ketones and acetone.

PLEASE HELP!!!

I have c,b,f,g,e,h,a,d........does anybody know for sure???

Thanks for your help, this one has been stumping me for a bit!

Michelle:confused:

[2ndyearstudent, CNA]

My guess is h, c, b, f, e, g, a, d

h The first thing that happens is the acidosis, increased H+ in the blood.

c The H+ ride the gradient into cells, and K+ is exchanged as the cells try to keep the membrane potential.

b The H+ moving into the cells decreases the amount of extracellular H+ (although this seems pretty obvious)

f The K+ coming out of the cells increases the serum K+ (again, duh)

e The kidneys figure, I don't really need all this potassium and increase excretion.

g This causes a total (intra and extracellular) potassium defecit.

a Some genius finally decides to treat the problem.

d The body stops producing acidic ketones, the serum H+ levels drop and the H+ comes back out of the cells in exchange for the K+ they spit out earlier.

If history repeats itself, your teacher has some rationale known only to her that will provide a different answer.

[2ndyearstudent, CNA]

I realized a goof on one of the items. I think your instructor wants the treatment of the problem to be the primary factor that reductes H+ in the blood, not the H+/K+ exchange.

Here's what I think is the correct answer:

h, c, f, e, g, a, b, d

h The first thing that happens is the acidosis, increased H+ in the blood.

c The H+ ride the gradient into cells, and K+ is exchanged as the cells try to keep the membrane potential.

f The K+ coming out of the cells increases the serum K+

e The kidneys figure, I don't really need all this potassium and increase excretion.

g This causes a total (intra and extracellular) potassium defecit.

a Some genius finally decides to treat the problem.

b The cells start using glucose from the blood instead of breaking down fats, reducing serum H+

d As serum H+ levels drop, the H+ comes back out of the cells in exchange for the K+ they spit out earlier. But until take in some more K+, you will probably have a deficit.

[lvnlrn]

My guess is h, c, b, f, e, g, a, d

If history repeats itself, your teacher has some rationale known only to her that will provide a different answer.

So true...I hate questions like this, because I never know which comes first, "b" or "f"? Technically they're happening almost simultaneously...I always miss questions like these because I overthink them

Good job, 2ndyearstudent; I came up with the same answer but I transposed the "b" and "f". I'd be curious to know what the teacher said was the right answer?

And just a side note, the insulin won't fix the hypokalemia...in fact it would make serum concentrations worse as insulin drives potassium into the cell. Which is why dextrose with insulin is used for hyperkalemia. :)

[petriem1]

Thank you both for your help, I will let you know how it turns out!!:)