Which of the following metabolic disorders is associated with hypokalemia?
**Core Concept**
Metabolic disorders can lead to hypokalemia, a condition characterized by low potassium levels in the blood. This can occur due to an imbalance in potassium intake, excessive loss, or redistribution. The kidneys play a crucial role in maintaining potassium homeostasis by regulating its excretion.
**Why the Correct Answer is Right**
The correct answer is C. Primary aldosteronism, also known as Conn's syndrome, is a condition characterized by excessive production of aldosterone, a hormone that promotes potassium excretion in the urine. This leads to hypokalemia as potassium is lost in the urine. The mechanism involves the activation of the mineralocorticoid receptor by aldosterone, which increases the expression of the sodium-potassium pump (Na+/K+-ATPase) in the collecting duct of the kidneys. This results in increased sodium reabsorption and potassium excretion.
**Why Each Wrong Option is Incorrect**
* **Option A:** Diabetes mellitus can cause hyperkalemia due to insulin deficiency, which impairs potassium uptake by cells. This leads to elevated potassium levels in the blood.
* **Option B:** Hypokalemia can occur in hypothyroidism due to decreased renal potassium excretion, but it is not the most direct association.
* **Option D:** Pheochromocytoma is a tumor of the adrenal gland that produces excessive catecholamines, leading to hypertension and hyperkalemia due to increased potassium release from cells.
**Clinical Pearl / High-Yield Fact**
Primary aldosteronism is often associated with hypertension and hypokalemia. A classic physical examination finding is the presence of "hypokalemic paralysis," characterized by muscle weakness and paralysis due to severe hypokalemia.
**Correct Answer:** C. Primary aldosteronism.