Which electrolyte abnormality is present in the described mesenteric ischemia scenario with a potassium of 7.6?

• A. Hyperkalemia
• B. Hypokalemia
• C. Hypernatremia
• D. Hypocalcemia

Answer: (A)

When tissue is severely ischemic, potassium leaks from injured cells into the bloodstream, and acidosis from anaerobic metabolism pushes even more potassium out of cells. In mesenteric ischemia, this cellular breakdown plus potential kidney hypoperfusion (reducing potassium excretion) can lead to a markedly elevated serum potassium, such as 7.6. This combination makes hyperkalemia the expected electrolyte abnormality in this scenario.

Hyperkalemia fits because potassium is largely intracellular and is released with cell injury; hypokalemia would imply potassium loss or shifts that aren’t driven by tissue necrosis; hypernatremia would require excess sodium, which isn’t the hallmark of this event; hypocalcemia isn’t the primary change driven by acute intestinal ischemia.