November 9, 2015

Tall T waves due to hyperkalemia

An elderly hypertensive was admitted due to generalized weakness and nausea for a month and 2 weeks watery diarrhea.

This is the ECG. What do you expect to see in the lab of this patient?

This is sinus rhythm with tented T (tall and narrow) waves from V3 to V6.

Labs came back: WBC and PC - N, Hb 7.6 (L), Trop - 0.09, BG - 120, Na 135 (N), K 8.5 (H), CO2 9 (L), BUN 150's (H), Creatinine 19, UA showed pyuria and proteinuria. USD showed bilateal hydronephrosis.

So there was severe hyperkalemia due to renal failure (acute on chronic) prob obstructive uropathy with hypertensive nephrosclerosis. 


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