Dip Int Med(SA) Practice Questions - Diploma In Internal Medicine Of The College Of Physicians Of South Africa Dip Int Med(SA) Exam

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A 62-year-old man with chronic kidney disease (baseline creatinine 180 µmol/L) presents with generalized muscle weakness. His ECG reveals tall, peaked T waves, broadened QRS complexes, and prolonged PR intervals. Serum potassium is reported as 7.2 mmol/L. What is the mandatory immediate first step in medical management?

Administer IV 10% Calcium Gluconate 10-20 mL over 5-10 minutes under ECG monitoring Administer oral Sodium Polystyrene Sulfonate (Resonium) 30 g Initiate IV Insulin 10 units in 50 mL 50% Dextrose over 15 minutes Perform urgent emergent hemodialysis without any medical temporizing measures

Correct Answer:

Administer IV 10% Calcium Gluconate 10-20 mL over 5-10 minutes under ECG monitoring

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