Paediatric emergencies: hyperkalaemia management: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Paediatric emergencies: hyperkalaemia management

Sample item

A child with acute kidney injury has a serum potassium of 7.5 mEq/L with peaked T waves and wide QRS complexes. Which is the first drug to protect the heart?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Intravenous calcium gluconate

Calcium gluconate stabilises the myocardial membrane within minutes in hyperkalaemia with ECG changes. Insulin with dextrose, salbutamol and bicarbonate shift potassium, and resins, diuretics or dialysis remove it.

Option by option

  • A. Intravenous potassium-sparing drug

    Potassium-sparing drugs worsen hyperkalaemia.

  • B. Intravenous furosemide

    Furosemide helps removal but is not cardioprotective.

  • C. Intravenous calcium gluconate (correct)

    Correct. Calcium is the immediate cardioprotective step.

  • D. Oral calcium resonium

    Resins act slowly and are not first.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, Intravenous calcium gluconate. Calcium gluconate stabilises the myocardial membrane within minutes in hyperkalaemia with ECG changes.

Why is "Intravenous potassium-sparing drug" not the answer?

Potassium-sparing drugs worsen hyperkalaemia.

Why is "Intravenous furosemide" not the answer?

Furosemide helps removal but is not cardioprotective.

Why is "Oral calcium resonium" not the answer?

Resins act slowly and are not first.

What concept does this question test?

It tests Paediatric emergencies: hyperkalaemia management in Pediatrics. Insulin with dextrose, salbutamol and bicarbonate shift potassium, and resins, diuretics or dialysis remove it.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Paediatric emergencies: hyperkalaemia management?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.