View Full Version : Frequently tested - hyperkalemia management - usmle step 3

08-27-2013, 01:40 PM

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 and search "Next step in management USMLE STEP 3"

Google search " Next step in management USMLE Step 3

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