A 58-year-old male with known chronic kidney disease (eGFR 15 mL/min) presents with acute breathlessness, bilateral pulmonary crackles, and peripheral...

Question

A 58-year-old male with known chronic kidney disease (eGFR 15 mL/min) presents with acute breathlessness, bilateral pulmonary crackles, and peripheral oedema. His blood pressure is 190/110 mmHg. His blood gas shows pH 7.28, potassium 6.8 mmol/L, and bicarbonate 14 mmol/L. What is the priority treatment sequence?

Accepted Answer

Calcium chloride (cardiac stabilisation) → insulin/dextrose (potassium shift) → nebulised salbutamol → urgent dialysis

Answer

Intubation and ventilation → dialysis

Answer

Fluid restriction alone → observe and transfer

Answer

Furosemide IV → morphine → GTN → dialysis

Answer

GTN infusion → furosemide → sodium bicarbonate only

uk-dipimc MCQ (SBA): Hyperkalaemia with Pulmonary Oedema