A 60-year-old woman on lisinopril and spironolactone presents with lethargy and muscle weakness. K⁺ is 6.8 mmol/L. ECG shows peaked T waves and loss

Question

A 60-year-old woman on lisinopril and spironolactone presents with lethargy and muscle weakness. K⁺ is 6.8 mmol/L. ECG shows peaked T waves and loss of P waves. eGFR is 42 mL/min/1.73m². She recently started ibuprofen for knee pain. What is the most likely precipitant?

Accepted Answer

NSAIDs (ibuprofen) in combination with RAAS blockade and MRA

Answer

Spironolactone alone

Answer

Lisinopril alone

Answer

Rhabdomyolysis

Answer

Dietary potassium excess

Triple Whammy Hyperkalaemia — RACP Adult Medicine MCQ

A 60-year-old woman on lisinopril and spironolactone presents with lethargy and muscle weakness. K⁺ is 6.8 mmol/L. ECG shows peaked T waves and loss of P waves. eGFR is 42 mL/min/1.73m². She recently started ibuprofen for knee pain. What is the most likely precipitant?