Answer:USMLE step 2 USMLE 23:A 42-year-old man with acute renal failure is confused

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Correct Answer: E
Explanation:
the earliest ECG evidence of hyperkalemia usually appears in the T waves The variety of changes include: Increased amplitude and peaking of the T wave PR interval prolongation QRS interval prolongation Flattening of the P wave. A plasma potassium of >6.5mmol/l should be treated urgently unless it is an artefact. Hyperkalemia may have a variety of causes: Renal failure; Excess potassium replacement therapy;Acidosis from any one of various causes (diabetic ketoacidosis, lactic acidosis, etc.); Presence of insufficient corticosteroids (Addison's disease). As in hypokalemia, there may be a poor correlation between serum potassium levels and the typical ECG changes.


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