hyperkalemia

Question 1

causes of hyperkalemic

Answer 1

reduced GFR -> not enough k excreted

trauma/burns/homolysis -> cell death -> k release

DKA -> K shifts from intra to extra

Addison disease -> no aldosterone -> no K release

acidosis -> k/h exchanger -> k reabsorbed

hypovolemic -> high serum osmo -> k moves intra to extra

drugs

blood transfusion

Question 2

what drugs cause hyperkalemia

Answer 2

ACEI
thiazide diuretics
BB -> inhibits na/k pump
digoxin -> inhibits na/k pump

Question 3

pseudohyperkalemia

Answer 3

haemolysis due to tourniquet on for too long

Question 4

symptoms of hyperkalaemia

Answer 4

MURDER (muscle weakness, urine (oliguria, Auriea), respiratory distress, decreased cardiac contractility, ECG, reflex (hyporeflexia))

Question 5

investigations for hyperkalaemia

Answer 5

U+E, aldosterone level, FBC, BM, ABG, digoxin levels, CK, LDL (homolysis)

Question 6

ECG changes in hyperkalemia

Answer 6

tall tented T waves, wide QRS, prolonged PR interval, flattened P waves, AV block, bradycardia, sine wave

Question 7

treatment of hyperkalaemia with ECG changes

Answer 7

calcium gluconate stabilises cardiac membranes for 30 min, insulin + glucose infusion (shifts k intracellular), salbutamol (na/k pumps intracellularly), hco3 to counter acidosis

calcium polystyrene sulfonate resin (removes k for GI), furosemide, dialysis