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

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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
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3
Q

ECG changes

A

Tented T
No P
Broad QRS
Sinusoidal => asystole

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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

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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

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