Hyper/Hypo Kalemia

Question 1

Hyperkalemia
Causes?

Answer 1

AKI
Drugs - NSAIDs, spironolactone, ACE-I
Addisons
DKA (+dm)
Increased intake
Renal tubular acidosis T4

Question 2

Hyperkalemia
Range?
Emergency level?

Answer 2

K+ >5.5 mmol/L
>6.5 mmol/L = emergency

Question 3

Hyperkalemia
Pathology?

Answer 3

Increased K+ decreases threshold AP therefore easier depolarisation + ABNORMAL heart rhythms

Question 4

Hyperkalemia
Sx?

Answer 4

Fast irregular pulse (VF risk)
Myalgia

Question 5

Hyperkalemia
Dx?
ECG?

Answer 5

ECG =
GO = absent p waves
Go long = prolonged PR
Go tall = tall tented t waves
Go wide = Wide qrs

+ K+ conc on U+Es

Question 6

Tx for Hyperkalemia

Answer 6

If urgent = calcium gluconate 1st line - stabilise cardiac membrane - then insulin and dextrose
Non urgent = Insulin and dextrose

Question 7

Hypokalaemia
Range?
emergency level?

Answer 7

K+ <3.5mmol/L
<2.5mmol/L = emergency

Question 8

Hypokalaemia
Causes?

Answer 8

Thiazides + loop diuretics - Na+ sparing, K+ excretion
CONNs
Renal tubukar acidosis 1+2
GI losses
Low intake

Question 9

Hypokalaemia
Sx?

Answer 9

Hypotonia
Hyporeflexia
Arrhythmias
(esp AF)

Question 10

Hypokalaemia
Dx?
ECG?

Answer 10

Low K+ conc

ECG = small inverted T waves, Prominent U waves, ST depression, PR prolongation
(PR U ST T)

Question 11

Hypokalaemia
Tx?

Answer 11

K+ replacement
aldosterone antagonist (spironolactone)