Wed17November0747PM 1

A 40-year-old man presents with acute weakness and palpitations.

Investigations reveal:

Sodium 143 mmol/L (137-144)

Potassium 8.0 mmol/L (3.5-4.9)

Urea 35 mmol/L (2.5-7.5)

Creatinine 450 µmol/L (60-110)

Bicarbonate 5 mmol/L (20-28)

Which of the following is the best immediate therapy?

(Please select 1 option)

Intravenous dextrose and insulin

Intravenous sodium bicarbonate

Intravenous calcium gluconate Correct

Nebulised salbutamol

Rectal calcium resonium

Explanation

This patient appears to have acute renal failure with severe acidosis, hyperkalaemia, and palpitations.

The patient should be rehydrated, treated with insulin, and given bicarbonate, but the immediate treatment, particularly in the context of a life-threatening arrhythmia, would be calcium gluconate.

Answer Statistics

1

10%

2

2%

3

88%

4

2%

Times answered: 262