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Gen Med (Renal) > Clinical Chemistry 2 - Potassium > Flashcards

Clinical Chemistry 2 - Potassium Flashcards

1
Q

The concentrations of potassium in the ECF tend to vary in association with which other ion?

A

Hydrogen

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2
Q

A plasma potassium level of greater than what is a medical emergency?

A

> 6.5mmol/l

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3
Q

If a patient has hyperkalaemia, why is urgent treatment indicated?

A

There is a risk of ventricular fibrillation (and cardiac arrest)

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4
Q

What are some concerning signs and symptoms in someone with hyperkalaemia?

A

Irregular pulse/palpitations, chest pain, muscle weakness, light-headedness

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5
Q

What happens to T waves in an ECG of hyperkalaemia?

A

Tall, tented T waves

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6
Q

What happens to P waves in an ECG of hyperkalaemia?

A

Small or absent P waves

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7
Q

What happens to the QRS complex in an ECG of hyperkalaemia?

A

Wide

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8
Q

Which acid-base disorder is associated with hyperkalaemia?

A

Metabolic acidosis

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9
Q

What are some drugs which may cause hyperkalaemia?

A

Potassium-sparing diuretics, ACE inhibitors/ARBs

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10
Q

How is non-urgent hyperkalaemia managed?

A

Treat the underlying cause and review medications

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11
Q

What drug can be given to patients with non-urgent, long-term hyperkalaemia?

A

Calcium resonium (polystyrene sulfonate resin)

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12
Q

Calcium resonium (polystyrene sulfonate resin) brings down potassium levels over what time period?

A

A few days

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13
Q

When should hyperkalaemia be treated as an emergency, even if the level isn’t > 6.5mmol/l?

A

If there is any evidence of myocardial hyper-excitability

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14
Q

Which investigations should be performed immediately on someone with suspected hyperkalaemia?

A

ABG/VBG and ECG

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15
Q

How should the cardiac membrane be stabilised in someone with hyperkalaemia?

A

10ms 10% calcium gluconate

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16
Q

How should potassium be driven back into cells in someone with hyperkalaemia?

A

10 units Actrapid in 50mls 50% dextrose

17
Q

Other than insulin and dextrose, what are some other medications which can drive potassium into cells?

A

Salbutamol and sodium bicarbonate

18
Q

What is required if medical treatment fails to normalise the potassium level in someone with hyperkalaemia?

A

RRT

19
Q

A plasma potassium level of less than what requires urgent treatment?

A

< 2.5mmol/l

20
Q

Hypokalaemia exacerbates toxicity associated with which drug?

A

Digoxin

21
Q

What drugs can be responsible for causing hypokalaemia?

A

Diuretics (non-potassium sparing)

22
Q

What acid-base balance is associated with hypokalaemia?

A

Metabolic alkalosis

23
Q

If a patient is on diuretics, what can be used as an indicator that hypokalaemia is longstanding?

A

High bicarbonate

24
Q

Hypokalaemia goes hand in hand with which other electrolyte abnormality?

A

Hypomagnesaemia

25
Q

Symptoms of hypokalaemia are rare. If they do occur, what may they include?

A

Muscle weakness, hypotonia/reflexia, palpitations, light-headedness, constipation

26
Q

Hypokalaemia predisposes to which arrhythmias?

A

Ectopic beats, AV block, atrial and ventricular fibrillation

27
Q

What happens to the PR interval on an ECG of someone with hypokalaemia?

A

Progressively lengthened

28
Q

What happens to the ST segment on an ECG of someone with hypokalaemia?

A

Depressed

29
Q

What happens to the T waves on an ECG of someone with hypokalaemia?

A

Flattened

30
Q

What is the treatment of mild hypokalaemia (i.e. potassium > 2.5mmol/l, no symptoms)?

A

Oral potassium supplements

31
Q

What is the treatment of severe hypokalaemia (i.e. potassium < 2.5mmol/l and/or dangerous symptoms)?

A

IV potassium supplementation

32
Q

No more than how many mmol/l of potassium should be given in one hour?

A

20mmol

Gen Med (Renal) (18 decks)

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