arrhythmias/hyperkalemia

Lab Parameter	Value	Reference Range
Serum Potassium	7.1 mmol/L	3.5-5.0 mmol/L
Serum Creatinine	240 µmol/L	50-100 µmol/L
eGFR	25 mL/min/1.73m²	>60 mL/min/1.73m²
Serum Glucose	8.5 mmol/L	3.9-6.1 mmol/L
Sodium	138 mmol/L	135-145 mmol/L
Bicarbonate	18 mmol/L	22-29 mmol/L

See Explanation

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Question 2 / 2

683c98b6bf0c2b5ee08e4a49

Cardiology

arrhythmias

hyperkalemia

Case History

A 50-year-old male presents to an urgent care clinic complaining of increasing generalized weakness, intermittent substernal chest discomfort described as a heavy pressure, and significantly reduced urine output over the past three days. His medical history includes long-standing hypertension and type 2 diabetes mellitus, for which he takes ramipril and metformin. He admits to recent dietary indiscretion, including increased consumption of potassium-rich foods, and missed several doses of his diuretics. Physical examination reveals a blood pressure of 145/90 mmHg, heart rate of 55 beats per minute, respiratory rate of 18 breaths per minute, and he appears lethargic. Cardiopulmonary auscultation is unremarkable, and there is no peripheral edema. His initial electrocardiogram shows tall, peaked T waves, a prolonged PR interval, and widening of the QRS complex. Considering these findings, what is the most likely diagnosis and the immediate, critical therapeutic intervention?

Lab Parameter	Value	Reference Range
Sodium	138 mmol/L	135-145 mmol/L
Potassium	7.1 mmol/L	3.5-5.0 mmol/L
Chloride	100 mmol/L	95-105 mmol/L
Bicarbonate	20 mmol/L	22-29 mmol/L
Urea	28.5 mmol/L	2.5-7.5 mmol/L
Creatinine	280 µmol/L	60-110 µmol/L
Glucose	15.2 mmol/L	3.9-7.8 mmol/L (fasting)
Hemoglobin	135 g/L	130-170 g/L
White Blood Cell Count	8.5 x 10^9/L	4.0-11.0 x 10^9/L

A ) Acute myocardial infarction and urgent coronary angiography.

B ) Ventricular tachycardia secondary to hypocalcemia and intravenous magnesium sulfate.

C ) Severe hyperkalemia with cardiotoxicity and intravenous calcium gluconate.

D ) Acute renal failure with symptomatic hyperkalemia and emergent hemodialysis.

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