A man is found after a long lie with dark urine, a creatine kinase of 40 000 U/L and a potassium of 6.8 mmol/L. What is the most important initial treatment?
Answer and explanation
Correct answer: A. Large-volume intravenous fluid, cardiac monitoring and treatment of the hyperkalaemia
- Step 1: Muscle breakdown releases myoglobin and potassium, risking acute kidney injury and arrhythmia. Step 2. Early large-volume IV fluid maintains urine output to clear myoglobin, and hyperkalaemia is treated urgently. Answer: Large-volume intravenous fluid, cardiac monitoring and treatment of the hyperkalaemia. Why not the others: Restricting fluid worsens kidney injury. Diuretics alone do not replace volume. Potassium supplements are dangerous with a level of 6.8.
Practise more Acute and emergency care.
Free questions with an explanation for every one, and full timed UKMLA Applied Knowledge Test (MSRA-style single best answer) mock tests.
More Acute and emergency care questions
- A man develops facial swelling, wheeze and hypotension minutes after a wasp sting. What is the most appropriate immediate drug treatment in…
- During cardiac arrest in a monitored ward bed the rhythm is ventricular fibrillation, and three shocks have been delivered. Which drugs are…
- What are the recommended rate and depth of chest compressions for an adult in cardiac arrest, according to Resuscitation Council UK?
- A patient in pulseless electrical activity after a road collision has distended neck veins, absent breath sounds on the left and a deviated…
- Which combination best describes the components of the Sepsis Six bundle that should be completed within the first hour?
- A woman with type 1 diabetes presents with ketoacidosis. Her admission potassium is 2.8 mmol/L. What is the most appropriate approach to ins…