General Medicine — MCQs

Q: Hyperkalemia is due to all of the following except:

Alkalosis. ***Alkalosis*** - **Alkalosis** causes an **intracellular shift of potassium** in exchange for hydrogen ions [1], typically leading to **hypokalemia**, not hyperkalemia [1]. - This shift helps to buffer the alkaline state by moving hydrogen ions out of cells. *Acute renal failure* - In **acute renal failure**, the kidneys lose their ability to excrete potassium, leading to its accumulation in the blood. - This impaired **potassium excretion** is a common cause of **hyperkalemia** in these patients. *Addison's disease* - **Addison's disease** (primary adrenal insufficiency) results in decreased production of **aldosterone**, a hormone that promotes potassium excretion [1]. - Reduced **aldosterone** activity leads to reduced potassium secretion in the renal tubules, causing **hyperkalemia** [1]. *Excess hemolysis* - **Hemolysis** refers to the breakdown of red blood cells, which contain a high concentration of **intracellular potassium** [1]. - When red blood cells lyse, they release their intracellular potassium into the bloodstream, directly causing **hyperkalemia**.

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