The section, EDAIC MCQ with explanation, covers a different topic each day with the intent that candidates can prepare one small topic each day, making steady progress in their exam preparation.
Question: management of life-threatening hyperkalaemia includes
- Intravenous sodium bicarbonate
- Intravenous calcium gluconate
- Intravenous corticosteroids
- GIK infusion
- Oral resonium
Answers:
- true
- true
- false
- false
- true
Explanation:
The treatment of emergency hyperkalaemia is aimed at:
- Membrane stabilisation (Hyperkalemia depolarizes the cell membrane, slows ventricular conduction, and decreases the duration of the action potential).
- calcium gluconate (10 ml of 10% over 10 min)
- hypertonic saline ( 50 ml of 3%NaCl iv push)
- Redistribution of potassium (intracellular mobilisation to reduce circulating levels)
- Insulin and glucose infusion (10 units in 25-40 grams of glucose over 20 min)
- Beta-agonists (albuterol, 20mg/4ml NS nebulised over 10 min)
- Enhancing elimination
- Loop diuretics (40-80 mg furosemide)
- Sodium bicarbonate (aids in an intracellular shift too by causing alkalosis)
- Decreasing absorption (Sodium polystyrene sulfonate, Kayexalate or Kionex 15–30 g in 15–30 mL of 70% sorbitol orally). The onset of effect often takes 2 hours or more and is significantly variable.
- Hemodialysis
- Diagnosis and management of the underlying cause
- although chronic steroid use can cause hypokalemia by excessive loss in urine, these are not helpful in acute management.
- GIK infusion (glucose/insulin/potassium) contains K and is not suitable for hyperkalemia treatment.
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‘EDAIC MCQ with explanation’ covers a different topic each day with the intent that candidates can prepare one small topic each day, making steady progress in their exam preparation.
