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Renal > 1: Fluid + Electrolyte - Hyperkalaemia > Flashcards

1: Fluid + Electrolyte - Hyperkalaemia Flashcards

1
Q

Define hyperkalaemia

A

Potassium greater than 5.5

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2
Q

What are three causes of hyperkalaemia

A
  • Reduced excretion
  • Shift from intracellular to extracellular
  • Pseudohyperkalaemia
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3
Q

What causes pseudo-hyperkalaemia

A

Lysis of cells causing hyperkalaemia due to incorrect taking of blood

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4
Q

What causes hyperkalaemia due to decreases excretion of potassium

A

AKI

CKD

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5
Q

What endocrine causes of hyperkalaemia

A

Addison’s

= Aldosterone deficiency

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6
Q

What medications can cause hyperkalaemia

A

ACEi

Potassium-sparing diuretics

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7
Q

What are two other causes of hyperkalaemia

A

TLS

Renal Tubular Acidosis

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8
Q

What may cause shift of potassium from intracellular to extracellular

A 
Acidosis
B-Blockers
Insulin Deficiency 
Heparin 
Digoxin
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9
Q

Why does acidosis cause hyperkalaemia

A
  • Excess H+ decreases activity Na+-H+ ATPase
  • This leads to reduce intracellular concentration of Na+
  • This increases Na+-k+ ATPase and increases extracellular potassium concentration
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10
Q

Describe clinical presentation of hyperkalaemia

A
  • Arrhythmias (AV block, VF)
  • Muscle weakness
  • Loss deep tendon reflex
  • Nausea and Vomitting
  • Diarrhoea
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11
Q

What investigations should be ordered in hyperkalaemia

A

ABG
ECG
RFTs

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12
Q

What are 5 ECG signs of hyperkalaemia

A
  • Tall-tented T waves
  • Broad QRS
  • Flat P wave
  • Sinusoidal (merge T wave and QRS)
  • VF
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13
Q

Why are renal function tests ordered in hyperkalaemia

A

Assess for AKI and CKD as cause of hyperkalaemia

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14
Q

If hyperkalaemia is non-urgent what is used to treat

A

Calcium resonium

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15
Q

How does calcium resonium reduce serum potassium

A

Binds potassium in the gut, prevent absorption

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16
Q

How long does calcium resonium take to decrease serum potassium

A

Days

17
Q

What hyperkalaemia should be treated urgently

A

> 6.5 or ECG changes

18
Q

How is hyperkalaemia immediately managed

A

IV Calcium Gluconate

Or Chloride

19
Q

What is the role of IV calcium gluconate

A

Stabilises cardiac membrane for 30-60 minutes. It does not, lower serum potassium

20
Q

What is given following calcium gluconate (or chloride) in management of hyperkalaemia

A

Insulin

21
Q

What is the role of insulin

A

Causes shift of potassium from extracellular to intracellular

22
Q

What else is given in management of hyperkalaemia

A

Salbutamol

23
Q

When should salbutamol be given carefully

A

History IHD - due to tachycardia increasing strain on the heart

24
Q

What is the main complication of hyperkalaemia

A

VF

Renal (15 decks)

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