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Dynamic hyperinflation in status asthmaticus — RCPSC IM MCQ

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HardCritical CareDynamic hyperinflation in status asthmaticusRCPSC IM

A patient with stage 4 CKD has potassium 5.9 mmol/L on two non-hemolyzed samples, normal ECG and no acute illness. Ramipril and spironolactone are both prescribed for HFrEF. What is the most appropriate next step?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Review causes and medications, then institute a potassium-lowering plan

Explanation lettering: B = shown as A · A = shown as B · E = shown as D · D = shown as E

A is correct: stable chronic hyperkalemia requires confirmation, review of contributors and a plan that balances potassium control with beneficial RAAS therapy. B and C are for emergencies. D may sacrifice prognostic therapy unnecessarily. E is unsafe.

Reference: Emergency Care BC, Hyperkalemia: https://emergencycarebc.ca/clinical_resource/clinical-summary/hyperkalemia-diagnosis-and-treatment/