TYK292

A 1 week-old male is diagnosed with ARF in the setting of newly diagnosed posterior urethral valves. His initial serum potassium is 6.3 mMol/L. Which of the following EKG findings would indicate a possible need for renal replacement therapy?

a) Prolonged QTc with intermittent Q-waves

b) Prolonged PR interval and peaked T waves

c) Mobitz type 1 (Wenckebach) second degree AV block

d) Right ventricular hypertrophy with p-pulmonale

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Answer

Answer b. Hyperkalemia may be medically managed in the renal failure patient; however, the presence of EKG findings is very worrisome and warrants aggressive therapy with possible initiation of renal replacement therapy. The first signs of electrocardiographic defects due to hyperkalemia are large (“peaked”) t-waves and prolongation of the PR interval.

Notes

This question originally printed in the Pediatric Anesthesiology Review Topics kindle book series, and appears courtesy of Naerthwyn Press, LLC.

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