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Life-threatening hyperkalaemia — RACP Written MCQ

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EasyNephrologyLife-threatening hyperkalaemiaRACP Written

A 69-year-old woman with CKD and heart failure is taking ramipril and spironolactone. Potassium is 6.8 mmol/L and ECG shows peaked T waves with QRS widening. What is the most important next step?

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

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Correct answer: D — Intravenous calcium gluconate with urgent potassium-lowering treatment

ECG changes in severe hyperkalaemia require immediate myocardial membrane stabilisation with intravenous calcium, followed by therapies to shift and remove potassium.

Reference: Therapeutic Guidelines: Kidney and Urinary; Kidney Health Australia principles