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Flashcards in Hyperkalemia Deck (15):
0

Hyperkalemia is bad.

yes,

1

4 causes of pseudohyperkalemia? (the K+ is actually normal)

In vitro hemolysis.
Leukocytosis.
Thrombocytosis.
Fist-clenching during blood draw.

2

Is excessive K+ intake alone a common cause of hyperkalemia?

Nope.

3

3 groups of causes of reduced K+ excretion?

Reduced GFR.
Defective RAAS.
Inadequate distal tubule Na+ / volume flow.

4

Findings consistent with insufficient aldosterone can either be...

Insufficient aldosterone.
Impaired response to aldosterone.

5

6+ causes of hyperkalemia caused by abnormal cell shifts?

Insulin deficiency
Hypertonicity
Metabolic acidosis
Drugs
Exercise
Tissue damage / cell lysis
(and Hyperkalemic periodic paralysis....??)

6

4 clinical manifestations of hyperkalemia?

ECG changes.
Muscle weakness/paralysis.
Parathesias.
Impaired urinary acidification.

7

ECG changes in hyperkalemia?

Peaked T waves
Prolonged PR.
Loss of P waves.
Prolonged QRS. -> "sine wave" V fibrillation

8

What ECG changes associated with hyperkalemia should prompt you to treat?

Any changes. The progression to arrhythmia here is unpredictable.

9

What's the utility of calculating the Trans-tubular K+ Gradient (TTKG)?

It can give you a better idea of the extent of K+ secretion.

10

Formula for TTKG?

TTKG = ( urine [K] / plasma [K]) / (Uosm / Posm)

(this adjusts for water reabsorption in the collecting duct, in case you were worried)

11

3 steps in treating life-threateningly severe hyperkalemia?

1st: Antagonize cardiac effects.
2nd: Encourage K+ to move into cells.
3rd: Remove K+ from body.

12

How are the cardiac effects of hyperkalemia antagonized?

Calcium gluconate. (mechanism not clear - but it's the Ca++ that's important)

13

3 drugs that can be used to move K+ into cells in emergencies?

Insulin.
Beta-agonists (nebulized albuterol).
NaHCO3. (not that great... and hypertonicity can make hyperK worse).

14

3 ways to remove K+ in an emergency?

Loop diuretics.
Cation exchange resin (sodium polystyrene sulfonate, Kayexalate) - makes people poop out the K+ (but it may be more due to sorbitol...).
Hemodialysis.