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Old 08-27-2013
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Arrow Frequently tested - Hyperkalemia Management - USMLE STEP 3


Normal K+ range 3.5 - 5.5

Cause of hyperkalemia
- Acidosis, aldosterone deficiency, ACE inhibitors, ARBS
- Beta-blocker
- Crush injury,
- Digitalis, insulin deficiency
- Renal, RTA type IV

Frequently tested


Initial step get EKG

- If EKG shows peaked T, no P and prolong PR
- Treatment:
- 1st step, calcium gluconate (stabilizes the cardiac cell membrane) followedbyIV Insulin + glucose

- If EKG is normal:
- Treatment:
- IV Insulin (drives K+ into the cell) + Glucose (given to prevent hypoglycemia)
- IV Sodium Bicarbonate (Shifts K+ into the cell)
- Kayexelate (removes potassium from the body)

- If all of the above measures fail – Tx. (please check out the book for further details)

To get copy and check the reviews of the book please go to Amazon's
Next step in management USMLE STEP 3

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CCS-, Electrolytes-

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