new_n_lost
Politically InCorrect
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A 42-year-old man with acute renal failure is confused. His serum potassium is 8.1 mEq/L . The most likely abnormal ECG finding is
a) T wave inversion
b) PR interval of 300ms
c) QT interval of 0.4s
d) U wave
e) Tall tented T waves test
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| epica
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E . I know that tall T in hyperkalemia, but why T waves TESt.
Probably this is tricky and I am wrong? Without this "test "should be E for sure.
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| keepgoing
Forum Guru
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yes hyperkalemia--tall t but test never heard of ?
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| usmle4me
Forum Elite
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yes Tall T is right.
tall T in all leads can be due to hyperkalemia but is in few lead it is MI
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| girl^interrupted
Forum Elite
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Hyperkalimia: Peak T waves
Hypokalimia: U wave
Wolf parkinson white: Delta wave
Myocardial necrosis: Q wave
Q-T interval: Prolonged d/t some drugs, also d/t HYPOcalcemia b/c in Q-T interval there is greatest conductance to Calcium. so if ca decreases QT prolongs.
ST elevation: Transmural Ischemia(prinzemetal angina)
ST depression: Subendicardial ischemia(stable angina)
High Frequency P waves and low QRS complex : Third degree heart block( b/c SA beats at a faster rate than other pacemakers, hence peak P waves.)
please add to the list.....
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| girl^interrupted
Forum Elite
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PR interval of 300ms is looong(normal shud b less than 200)
Means there's first or second degree(type 1 mobitz) heart block
QT interval of 0.4s(400ms) is normal.
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| new_n_lost
Politically InCorrect
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Well Even i didnt hear of the Tall T waves Test but it was given in the Question's Choice.
The correct answer is E
Explanation
The earliest ECG evidence of hyperkalemia usually appears in the T waves The variety of changes include: Increased amplitude and peaking of the T wave PR interval prolongation QRS interval prolongation Flattening of the P wave. A plasma potassium of >6.5mmol/l should be treated urgently unless it is an artefact. Hyperkalemia may have a variety of causes: Renal failure; Excess potassium replacement therapy; Acidosis from any one of various causes (diabetic ketoacidosis, lactic acidosis, etc.); Presence of insufficient corticosteroids (Addison's disease). As in hypokalemia, there may be a poor correlation between serum potassium levels and the typical ECG changes.
Edited by new_n_lost on 03/21/07 - 01:42 PM
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| nandrolone
Forum Junior
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Rx for hyperkalemia
Glucose insulin drip
A resin like Sodium polysterearene sulphonate
Calcium gluconoate ( to antagonise action on heart - a physiological antagonist)
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