Insulin deficiency
Hyperosmolality (eg, hyperglycemia, mannitol)
Nonselective beta-blockers
Digitalis
Metabolic acidosis
Depolarizing muscle relaxant (succinylcholine)
Familial periodic paralysis
Tumor lysis syndrome
B) Cellular disruption with release of potassium:Crush injuries
Reperfusion of ischemic limbs
Massive blood transfusion
Lysed erythrocyte in large hematomas
Rhabdomyolysis
C) Decreased renal K+ excretion: Renal failureThrombocytosis (> 1,000,000/mm3)
Lekocytosis (> 50,000/mm3)
Hemolysis
HypokalemiaAcute alkalosis
Administration of glucose and insulin
Catecholamines
Increased gastrointestinal loss
Diarrhea, vomiting, high NG output
Mucus secreting colon tumors (eg, villous adenoma)
Excessive renal loss
Metabolic alkalosis
Magnesium deficiency
Hyperaldosteronism Hypercalcemia Mnemonic VITAMIN TRAPS:
Vitamin A and D intoxication
Immobilization
Thyrotoxicosis
Addison's disease/acidosis
Milk-alkali syndrome (from calcium antacids)
Inflammatory disorders
Neoplastic disease:
Multiple myleoma, lymphoma, metastatic breast cancer (associated with bone destruction)
Squamous cell carcinoma of the head and neck, esophagus, lung, kidney, and GI tract cancer (tumors that elaborate humoral factors causing ↑ Ca++)
Thiazides and other drugs (eg, lithium)
Rhabdomyolysis
AIDS
Paget's disease/ Parenteral nutrition/ Parathyroid disease (hyperparathyroidism)
Sarcoidosis
HypocalcemiaHypoparathyroidism
Acute pancreatitis
Massive soft tissue infection such as necrotizing fasciitis
Pancreatic/small bowel fistula
Vitamin D deficiency
Renal failure
Severe magnesium deficiency
Crush injuries
Massive blood transfusion
HypermagnesemiaAcute/chronic renal failure
Magnesium-containing antacids
Severe burns
Crush injuries
Rhabdomyolysis
Severe metabolic acidosis
HypomagnesemiaIntestinal malabsorption
Excessive GI loss (severe diarrhea, vomiting, enteric fistula, use of purgatives, NG suction)
Chronic use of loop diuretics
Drugs: cyclosporine, aminoglycosides, cisplatin, insulin
Alcohol abuse
Hyperaldosteronism
Hypercalcemia
Severe burns
Acute pancreatitis
Diabetic ketoacidosis
HypernatremiaHypervolemic hypernatremia: hypertonic Na load, Cushing syndrome, hyperaldosteronism
Hypo/euovolemic hypernatremia: diabetes insipidus, insensible water loss, diuretics
HyponatremiaHypervolemic hyponatremia:CHF,cirrhosis,severe nephritic syndrome, renal failure
Hypovolemic hyponatremia:vomiting, diuretics, diarrhea, dehydration
Euvolemic hyponatremia:Addison disease, hypothyroidism, SIADH
Other: primary polydepsia, post-transurethral resection of the prostate (TURP) syndrome, hyperglycemia