Hypo/HyperKalamemia

Question 1

What is hypokalamia?

Answer 1

Serum potassium <3.5mmol

Question 2

What can cause increased excretion so hypokalamia?

Answer 2

✶ Hyperaldosteronism
✶ Diuretics
✶ GI losses

Question 3

What is the presentation of hypokalamia?

Answer 3

1. Arrhythmias
2. Polyuria/polydipsia (interferes with ADH secretion causing nephrogenic diabetes)
3. Muscle weakness

Question 4

What does ECG for hypokalamia show?

Answer 4

1. U waves
2. Small or absent T waves
3. Prolonged PR interval
4. St depression
5. Long QT

Question 5

What can cause retristribtuion into cells causing hypokalamia?

Answer 5

✶ Insulin
✶ Salbutamol
✶ Metabolic alkalosis

Question 6

What is the management for hypokalamia when serum K 3.0-3.5mmol/L?

Answer 6

1. Oral SandoK tablets tds for 48hours

2. Regular monitoring of potassium levels

Question 7

What is the management for hypokalamia when serum K <3.0mmol/L?

Answer 7

1. IV KCl

2. Treat underlying cause

Question 8

What is hyperkalamia?

Answer 8

Potassium >5.5mmol/L

Question 9

What are the different types of hyperkalamia?

Answer 9

• Mild: 5.5 – 5.9
• Moderate: 6.0 – 6.4
• Severe: >=6.5

Question 10

What can cause hyperkalamia?

Answer 10

• Release from cells
• Rhabdomyolysis
• Acidosis
• Reduced excretion

Question 11

What are features of hyperkalamia?

Answer 11

1. Muscle weakness

2. Hypotonia

Question 12

What are ECG changes in hyperkalamia?

Answer 12

• Loss of p waves
• Tall tented T waves
• Widened QRS

Question 13

What is the management of hyperkalamia?

Answer 13

1. Stabilise myocardium: 10mL 10% Ca gluconate
2. Drive K+ into cells: 50ml 50% dextrose + 10U short acting insulin
3. Adjunct: Nebulised salbutamol
4. Treat any underlying cause

Question 14

What are complications of hyperkalamia?

Answer 14

1. Cardiac asystole

2. Arrhythmia