Hyperkalemia due to cellular shift is most strongly associated with which condition?

• A. Acidosis
• B. Chemotherapy
• C. Hemolysis
• D. Hypokalemia

Answer: (A)

Potassium moves between intracellular and extracellular compartments in response to acid-base changes. In acidosis, excess H+ enters cells, and to maintain electroneutrality, K+ exits cells into the bloodstream. This shifts potassium from inside cells to the extracellular space, raising serum potassium levels—hyperkalemia due to a cellular shift.

Other scenarios involve different mechanisms: hyperkalemia from chemotherapy would more likely come from tumor lysis and release of intracellular potassium; hemolysis can artifactually raise potassium during sample handling; hypokalemia is low potassium, not hyperkalemia.