Hyperkalaemia
Hyperkalaemia first: protect the heart with IV calcium if there are ECG changes, shift potassium with insulin and dextrose (salbutamol nebulisers also help), remove it with a diuretic or dialysis.
Treatment at a glance
- Calcium gluconate IV to protect the heart
- Insulin with dextrose and nebulised salbutamol to shift potassium into cells
What our notes say
- Hyperkalaemia first: protect the heart with IV calcium if there are ECG changes, shift potassium with insulin and dextrose (salbutamol nebulisers also help), remove it with a diuretic or dialysis. (Acute kidney injury)
- Hyperkalaemia (a) is also a massive transfusion risk but doesn't cause this specific tetany/QT picture. (Master Blood Transfusion: A Medical Quiz on Reactions & Tests)
- Hyperkalaemia gives tall peaked T waves, then a wide QRS and a sine-wave pattern. (Paediatrics end of second semester exam (MBPE 4300): 4 October 2022, cardiology,)
- Malnourished children develop hypokalaemia, not hyperkalaemia. (Paediatrics end of fourth year main exam: 1 July 2019, Paper One, 99 of 100 MCQs)
- Hyperkalaemia causes tall peaked T waves, then a flattened P wave, a widened QRS and finally a sine-wave pattern. (Cardiology Question Bank: 15 Clinical MCQs)
- Adding spironolactone, a potassium supplement or an NSAID, or having renal impairment, can lead to dangerous hyperkalaemia. (Cardiology Question Bank: 15 Clinical MCQs)
Study material on Hyperkalaemia
- ADRENAL NEOPLASMS — Adenoma vs Carcinoma
- Endocrine & Renal Pathology
- ADRENAL NEOPLASMS — Adenoma vs Carcinoma
- Paediatrics end of fourth year special supplementary exam: August 2019, Paper One, 87 of 100 MCQs
- Paediatrics end of fourth year main exam: 1 July 2019, Paper One, 99 of 100 MCQs and essays
- ADRENAL NEOPLASMS — Adenoma vs Carcinoma
- Endocrine & Renal Pathology — Must Know Notes
- Internal Medicine (MBIM 4100) special/supplementary exam, Paper Two: 14 August 2019
- Cardiology Question Bank: 15 Clinical MCQs
- Renal, Liver, Cardiac & Adrenal Function Tests for Year 3