Treatment resistant hypokalemia is caused by:

All the given options are known to cause hypokalemia but with different mechanisms. And only hypomagnesemia is described to cause treatment resistant hypokalemia among the following. Must Know: Systemic hypomagnesemia can cause treatment resistant hypokalemia due to 1. Reduced cellular uptake of potassium 2. Exaggerated renal excretion Administration of granulocyte colony stimulating factor will lead to hypokalemia as it is an anabolic state (White blood cell production). Vitamin B12 / Folic acid administration and total parenteral nutrition also will lead to hypokalemia with similar mechanism. Clay ingestion leads to hypokalemia due to decreased intake Toxic Barium ions inhibits K channels and inhibits the passive efflux of K leading to hypokalemia. Ref: Harrison, Edition-18, page-351.