The Information for Medical Professionals Section
Submitted by deb on Sat, 08/06/2011 - 23:52
There are times when a member says just the right thing, producing a post which is simply too good to let slide into obscurity. This is one of those posts;
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Hi "A",
Submitted by deb on Sat, 08/06/2011 - 23:06
A True Endocrine Emergency
Patients with Thyrotoxic Hypokalemic Periodic Paralysis typically present at the ER with an acute episode of paralysis involving the muscles of the extremities and limb girdles. The lower limbs are more frequently and severely involved than the upper. Weakness may be asymmetrical. Proximal strength is more severely impaired than distal strength. Respiratory and cardiac arrest are possible. Lie patient in coma position to avoid aspiration.
Cardiac Signs
Submitted by deb on Sat, 08/06/2011 - 22:54
Hyperkalemic Periodic Paralysis and Paramyotonia Congenita can occur singly or in combination.
While most attacks of Hyperkalemic Periodic Paralysis are brief and do not require emergency intervention, occasionally the serum potassium level will be high enough to cause cardiac distress, or muscle stiffness may interfere with respiration. Attacks of weakness in Paramytonia Congenita are usually mild to moderate in severity, but myotonia of chest, diaphragm and throat muscles can be life-threatening under some circumstances.
Talk to your physician
Submitted by deb on Fri, 08/05/2011 - 03:15
A free workbook to download for those who are in the diagnostic process, contains information on each type of PP, diagnostic testing, available therapies, how to determine episode triggers and work out a management plan. download here
First Actions:
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Respiratory and cardiac arrest are possible.
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Call for Cardiac Monitoring/EKG
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Draw electrolytes to determine serum K+
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Thyroid studies
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Provide 02 as thimble may not reflect 02 saturation due to cardiac dilitation
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Lie patient in coma position to avoid aspiration.
Submitted by deb on Wed, 07/27/2011 - 02:17
The normal renal response when hypokalemia is due to non-renal causes is a TTKG <2, where a TTKG >5 is indicative of increased secretion of K+ in the cortical collecting ducts. Thus a transtubular potassium concentration gradient (TTKG) of greater than 3.0 indicates hypokalemia of renal origin, while a value below 2.0 indicates intracellular shift of K+, as found in ion channelopathy hypokalemic periodic paralysis.
First Actions:
-
Respiratory and cardiac arrest are possible.
-
Call for Cardiac Monitoring/EKG
-
Draw electrolytes to determine serum K+
-
Provide 02 as thimble may not reflect 02 saturation
-
Lie patient in coma position to avoid aspiration.
Hyperkalemic Periodic Paralysis and Paramyotonia Congenita can occur singly or in combination.
Submitted by deb on Wed, 07/20/2011 - 19:51
Communication is key: Stephen Wilkins, MPH, writes of improving practice management through improved patient/physician communication and its impact on care, in Mind the Gap.
Submitted by deb on Sun, 07/17/2011 - 21:14
This information is based on diet recommendations found in many medical journal and textbook articles about Hyperkalemic Periodic Paralysis. (HyperKPP). According to physicians and dieticians those with HyperKPP should follow a diet which is high in carbohydrates and low in potassium. Because muscle tissue is stressed in the periodic paralyses it is also essential that patients obtain liberal amounts of high-quality protein.
Submitted by deb on Sun, 07/17/2011 - 20:38
Designed by the National Institutes of Health
This information is based on a diet designed at the National Institutes of Health in the 1960s for a young man with Hypokalemic Periodic Paralysis (HypoKPP). According to the NIH physicians and dietician Mary R. Emerson, plus many other medical authorities, those with HypoKPP should follow a diet which is high in protein, low in carbohydrate, and low in sodium.
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