Renal medicine: hyperkalemia: practice question

A General Medicine 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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General Medicine · Renal medicine: hyperkalemia

Sample item

A patient with acute kidney injury has potassium 6.8 mmol/L and ECG changes with peaked T waves. Which treatment stabilizes the cardiac membrane first?

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

The answer and the reasoning

A. Intravenous calcium

In severe hyperkalemia with ECG changes, intravenous calcium stabilizes myocardial membranes immediately. Measures such as insulin with glucose shift potassium intracellularly, while definitive removal addresses total body potassium.

Option by option

  • A. Intravenous calcium (correct)

    Correct. Calcium protects the myocardium while other therapies lower serum potassium.

  • B. Insulin without glucose in every patient

    Insulin should be paired with glucose unless hyperglycemia makes this unnecessary.

  • C. Loop diuretic after discharge

    Delayed outpatient diuresis is unsafe.

  • D. Oral sodium bicarbonate only

    Bicarbonate has limited context-dependent benefit and does not provide immediate membrane stabilization.

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 General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Intravenous calcium. In severe hyperkalemia with ECG changes, intravenous calcium stabilizes myocardial membranes immediately.

Why is "Insulin without glucose in every patient" not the answer?

Insulin should be paired with glucose unless hyperglycemia makes this unnecessary.

Why is "Loop diuretic after discharge" not the answer?

Delayed outpatient diuresis is unsafe.

Why is "Oral sodium bicarbonate only" not the answer?

Bicarbonate has limited context-dependent benefit and does not provide immediate membrane stabilization.

What concept does this question test?

It tests Renal medicine: hyperkalemia in General Medicine. Measures such as insulin with glucose shift potassium intracellularly, while definitive removal addresses total body 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 Renal medicine: hyperkalemia?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine 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.