Hypo and Hyperkalaemia

Question 1

What is hypokalaemia?

Answer 1

<3.5mmol per L

Question 2

What are symptoms of hypokalaemia?

Answer 2

Asymptomatic, fatigue, generalised weakness, muscle cramps and pain, palpitations

Question 3

What are signs of hypokalaemia?

Answer 3

Arrhythmias, muscle paralysis, rhabdomyolysis

Question 4

What causes increased excretion of potassium?

Answer 4

Drugs - diuretics, renal disease, GI loss, increased aldosterone

Question 5

What causes reduced intake of potassium?

Answer 5

Dietary deficiency

Question 6

What causes potassium to shift to intracellular?

Answer 6

Drugs - insulin, salbutamol

Question 7

What ECG changes are there in hypokalaemia?

Answer 7

Flat T waves, ST depression, prominent U waves, prolonged PR

Question 8

What investigations would you do?

Answer 8

ECG, urine osmolality, electrolytes, FBC, U&E

Question 9

How do you manage hypokalaemia?

Answer 9

Potassium, other electrolyte replacements, treat underlying cause

Question 10

What is hyperkalaemia?

Answer 10

> 5.5mmol per L

Question 11

What ECG changes are there in hyperkalaemia?

Answer 11

Tall tented T waves, prolonged PR, widening of QRS interval, small/absent P waves

Question 12

How do you manage hyperkalaemia generally?

Answer 12

ABC assessment, consider cardiac monitoring

Question 13

In hyperkalaemia, what do you give to protect the myocardium?

Answer 13

Calcium gluconate

Question 14

In hyperkalaemia, what do you give to drive potassium intracellularly?

Answer 14

Insulin + dextrose, nebulised salbutamol

Question 15

What can cause hyperkalaemia?

Answer 15

AKI, K+ sparing diuretics, Rhabdomyolysis, metabolic acidosis, Addison’s disease