Question of the Week # 314

Posted on January 30, 2012 by Archer USMLE Reviews

314) A 70-year-old man presented to the Emergency room with a 2-day history of increased thirst and frequency of urination. He reports generalized muscle weakness. His past medical history is significant for hypertension, diabetes mellitus and Stage III chronic kidney disease. His medications include Insulin Glargine, Lispro insulin, Enalapril , Atenolol and Spironolactone. Laboratory investigations reveal

Blood glucose 400mg%

Sodium 130 mEq/L

Potassium 7.5 mEq/L

Bicarbonate 26mEq/L

Chloride 100mEq/L

Creatinine 4.2mg%

An electrocardiogram is shown below:

Which of the following is the most appropriate next step?

A) Reduce the dose of Enalapril

B) Hemodialysis

C) Insulin Intravenous

D) Calcium Gluconate IV

E) Sodium biacrbonate IV

Filed under: Uncategorized, USMLE Test Prep | Tagged: ARCHER ACID-BASE, Archer cardiology, ARCHER ELECTROCARDIOGRAMS, ARCHER FLUID AND ELECTROLYTES, ARCHER NEPHROLOGY, dr.red nephrology lecture, USMLE ELECTROCARDIOGRAMS, USMLE STEP 3 CARDIOLOGY, usmle step 3 nephrology |

11 Responses

Roy, on January 30, 2012 at 2:55 am said:

Calcium gluconate

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Javeriah Umar Khan, on January 30, 2012 at 2:56 am said:

D) Calcium Gluconate IV

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abda, on January 30, 2012 at 3:14 am said:

obviously hyperkalemia

ddddddddddddddddd

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Michael, on January 30, 2012 at 5:30 am said:

d

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Mike, on January 30, 2012 at 8:00 pm said:

D – It is cardioprotective.

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preet, on January 30, 2012 at 9:08 pm said:

d IV calcium gluconate

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anu, on January 30, 2012 at 11:43 pm said:

d

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zoe, on March 6, 2012 at 12:45 am said:

ddd

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manuelchiky, on March 22, 2012 at 2:39 am said:

D……….

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David, on June 27, 2013 at 8:18 pm said:

D

calcium gluconate yhen iv insulin and nss

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Seb, on August 20, 2018 at 7:50 pm said:

Ekg exhibits tented T waves across all leads, which is hyperkalemia. Ekg evidence of hyperkalemia requires cardiac membrane stabilisation with iv calcium gluconate other) otherwise there is significant risk of progression to ventricular tachyarythmia /vfib. This should be given together with iv insulin and fluids to treat the hyperkalemia itself pushing the excess potassium from the ecf into the icf compartment. Resistant severe cases of hyperkalemia require removal to total body potassium with resins

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