Hyperkalemia ☺️ Flashcards
1
Q
Causes
A
AKI Drugs - K sparing diuretics, ACEi, ARB, Bb, ciclosporin, heparin Metabolic acidosis Addisons Rhabdomyolysis Massive blood transfusion
Pseudohyperkalemia if blood samples aren’t processed in time
2
Q
What are the clinical manifestations of hyperkalemia
- early
- late
How would this be detected?
A
Muscle weakness Urine ouput little/none => AKI Resp failure => from muscle weakness Decreased cardiac contractility => weak pulse, low HR Early muscle twitches Rhythm changes
3
Q
ECG changes
A
Tented T
No P
Broad QRS
Sinusoidal => asystole
4
Q
Presentation, investigations, management for Addisons
A
Postural hypotension, salt wasting -dehydration, prone to AKIs -high urea Low Na, high K Hyperpigmentation
Random cortisol
Synacthen test
-if primary => ACTH high prior to test
=> after test, cortisol <550
Hydrocortisone, fludrocortisone => MC, GC
5
Q
Initial management
Further management
A
IV Ca gluconate - stabilise cardiac
Insulin dextrose infusion
-can use neb salbutamol
Remove K
-Ca resonium/loop/dialysis
Stop exacerbating drugs
Treat underlying cause