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Diagnosis > Hyperkalaemia > Flashcards

Hyperkalaemia Flashcards

1
Q

What are the main differential diagnoses of hyperkalaemia?

A
  • Drug effects
  • Metabolic acidosis
  • Renal failure
  • Diabetic ketoacidosis
  • Addison’s disease
  • Recent blood transfusion
  • Spurious result due to haemolysis in specimen bottle
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2
Q

What suggests that drug effects are the cause of hyperkalaemia?

A

Administration of potassium supplements, ACE inhibitors, spironolactone, amiloride, triamterene

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3
Q

What confirms that drug effects are the cause of hyperkalaemia?

A

Normal potassium when drug reduced or stopped

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4
Q

How is hyperkalaemia caused by drug effects managed?

A

Withdrawal of suspect drug

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5
Q

What suggests metabolic acidosis, renal failure, or diabetic ketoacidosis as the cause of hyperkalaemia?

A
  • Obvious illness
  • Severe metabolic disturbance
  • Decrease pH
  • Decreased plasma HCO3-
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6
Q

What confirms that metabolic acidosis, renal failure, or diabetic ketoacidosis is the cause of hyperkalaemia?

A

Response to treatment of metabolic disturbance

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7
Q

How is hyperkalaemia caused by metabolic acidosis, renal failure, or diabetic ketoacidosis managed?

A
  • If K+ >6.5 and not falling, calcium gluconate IV
  • Glucose and insulin
  • Calcium Resonium
  • Treatment of cause
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8
Q

What suggests Addison’s disease as the cause of hyperkalaemia?

A
  • Fatigue
  • Decreased BP
  • Pigmented buccal mucosa and palmar creases
  • Decreased sodium
  • Increased potassium
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9
Q

What confirms that Addison’s disease is the cause of hyperkalaemia?

A
  • Decreased random and 9am cortisol
  • Increased ACTH
  • Poor response to hydrocortisone IV and normal saline
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10
Q

How is hyperkalaemia caused by Addison’s disease managed?

A
  • Hydrocortisone
  • Fludrocortisone
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11
Q

What suggests a blood transfusion as the cause of hyperkalaemia?

A

History

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12
Q

How is it confirmed that a recent blood transfusion is the cause of hyperkalaemia?

A

Fall of potassium after a few hours

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13
Q

How is hyperkalaemia caused by a recent blood transfusion managed?

A

Monitor potassium. If it is >6.5 and not falling, calcium gluconate IV, glucose and insulin, and Calcium Resonium

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14
Q

What suggests that hyperkalaemia is caused by a spurious result due to haemolysis in specimen bottle?

A

Laboratory reporting of haemolysis in the specimen bottle

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15
Q

What confirms that the cause of hyperkalaemia is a spurious result due to haemolysis in the specimen bottle?

A

Normal potassium when repeated

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Diagnosis (11 decks)

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