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Potassium in DKA — RACP Paediatrics MCQ

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ModerateEndocrinologyPotassium in DKARACP Paediatrics

A 4-year-old with DKA has been commenced on IV fluids and insulin. What electrolyte must be monitored most closely during treatment and supplemented when levels are confirmed?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Potassium

Potassium must be monitored closely during DKA treatment. Although serum potassium may be normal or elevated at presentation (due to acidosis-driven shift out of cells), total body potassium is depleted. As insulin drives potassium into cells and acidosis corrects, hypokalaemia can develop rapidly, risking cardiac arrhythmias. Potassium replacement begins once urine output is confirmed.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: DKA