Insulin: intravenous use and hyperkalaemia: practice question

A Pharmacology 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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Pharmacology · Insulin: intravenous use and hyperkalaemia

Sample item

A patient with a serum potassium of 7.0 mmol/L and ECG changes receives calcium gluconate. Which additional measure lowers serum potassium within minutes by shifting it into cells?

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

The answer and the reasoning

B. Intravenous regular insulin with glucose

Regular insulin is the standard formulation for intravenous use, and with glucose it drives potassium into cells by stimulating Na-K ATPase. Nebulised salbutamol adds to the effect. Calcium stabilises the myocardium without lowering potassium.

Option by option

  • A. Intravenous NPH insulin

    NPH is a suspension and not given intravenously.

  • B. Intravenous regular insulin with glucose (correct)

    Correct. Insulin with glucose shifts potassium intracellularly.

  • C. Intravenous potassium chloride

    Potassium chloride would be dangerous.

  • D. Oral calcium resonium only

    Resin acts slowly and removes potassium from the gut.

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 Pharmacology question

What is the answer to this Pharmacology question?

The best answer is B, Intravenous regular insulin with glucose. Regular insulin is the standard formulation for intravenous use, and with glucose it drives potassium into cells by stimulating Na-K ATPase.

Why is "Intravenous NPH insulin" not the answer?

NPH is a suspension and not given intravenously.

Why is "Intravenous potassium chloride" not the answer?

Potassium chloride would be dangerous.

Why is "Oral calcium resonium only" not the answer?

Resin acts slowly and removes potassium from the gut.

What concept does this question test?

It tests Insulin: intravenous use and hyperkalaemia in Pharmacology. Nebulised salbutamol adds to the effect. Calcium stabilises the myocardium without lowering potassium.

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 Insulin: intravenous use and hyperkalaemia?

Learn drugs as classes, then the exception in each class that an examiner would pick. Then use the flashcards and the other Pharmacology 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.