hyperkalaemia

Question 1

Aetiology of hyperkalaemia (3)

Answer 1

Increased intake of potassium
- IV therapy
- Increased dietary intake
Decreased excretion of potassium
- AKI and CKD
- Drugs (NSAIDs, spironolactone, ACE inhibitors)
- Renal tubular acidosis (T4)
- Addison’s disease
Potassium shifted to extracellular
- Metabolic acidosis/DKA
- Rhabdomyolysis

Other: trauma and burns

Question 2

Complications of hyperkalaemia (2)

Answer 2

Cardiac arrhythmias and arrest
- Hyperkalaemia is associated with broadening QRS complex

Question 3

Diagnosis + ECG of hyperkalaemia (5)

Answer 3

• High K+ on U+Es
  ECG:
  Go: Absent P Wave
  Go Long: Prolonged PR Interval
  Go Wide: Wide QRS
  Go Tall: Tall Tented T waves

Question 4

Effect of hyperkalaemia on Insulin, pH and Beta 2 receptors (3)

Answer 4

• Insulin deficiency as not enough K+ flows into the cell
• Acidosis (H+ in and K+ out)
• Beta blocker - inhibits pumping of K+ into cell

Question 4

Effect of hyperkalaemia on types of muscle (3)

Answer 4

• Smooth muscle cramping
• Skeletal mucle weakness due to overcontraction
• Cardiac arrythmias and arrest

Question 5

Pathophysiology of hyperkalaemia on the heart (3)

Answer 5

• High K+ decreases action potential
• Easier depolarisation
• Abnormal heart rhythms

Question 6

Potassium levels of hyperkalaemia and hypokalaemia and emergency hyperkalaemia (3)

Answer 6

Hyper ≥ 5mmol/L
Emergency hyper = ≥ 6.5mmol/L
Hypo < 3.5mmol/L

Question 7

Treatment for hyperkalaemia, urgent and non urgent (3)

Answer 7

If urgent: Calcium gluconate to stabilise cardiac membrane if there are heart problems, then insulin dextrose
Non-urgent: Insulin (+dextrose)

Question 8

Presentation of hyperkalaemia (4)

Answer 8

• Muscle weakness and cramps
• Parasthesia - pins and needles
• Palpitations
• Tachycardia (arrhythmias)