शैडोइंग अभ्यास: Understanding Hyperkalaemia (High Potassium) - वीडियो के साथ अंग्रेजी बोलना सीखें

Hi, this is Tom from ZeroToFinals.com.

In this video, I'm going to be going through hyperkalemia.

And you can find written notes on this topic at ZeroToFinals.com slash hyperkalemia or in the renal medicine section of the second edition of the Zero to Finals medicine book.

And you can find flashcards and questions to train your knowledge and help you remember the information for longer at members.zerotofinals.com So let's jump straight in

Hyperkalemia refers to a raised serum potassium,

a raised potassium level in the blood The main complication of hyperkalemia is cardiac arrhythmias such as ventricular fibrillation which can lead to cardiac arrest

Let's go through the ranges for the serum potassium levels and what they mean and the units for these levels are millimoles per litre.

A normal range for potassium is 3.5 to 5.3.

Mild hyperkalemia is 5.4 to 5.9.

hyperkalemia is 6.0 to 6.4 and severe hyperkalemia is 6.5 and above.

Let's go through the causes of hyperkalemia.

Conditions that can cause a raised serum potassium include acute kidney injury, chronic kidney disease, typically stage four or five,

rhabdomyolysis, adrenal insufficiency, and tumor lysis syndrome.

There are four classes of medications that can cause a raised serum potassium, and these are worth remembering.

Aldosterone antagonists, for example, spironolactone and apleronone.

ACE inhibitors, for example, Ramipril.

Angiotensin-2 receptor blockers, for example, Candisartan.

And non-steroidal anti-inflammatory drugs or NSAIDs, for example, ibuprofen or naproxen.

Hemolysis, which is the rupture of blood cells, which occurs during blood sampling can give a falsely elevated potassium, which is known as pseudohypocalemia.

The lab might indicate that they've noticed hemolysis in the sample and recommend a repeat sample to get an accurate potassium level.

Let's go through the ECG changes that occur with hyperkalemia.

The ECG changes with hyperkalemia are important to remember and they are tall peaked T waves, flattened or absent P waves, prolonged PR interval, and broad QRS complexes.

Finally, let's talk about the management of hyperkalemia.

Each hospital will have a policy and protocol to follow for patients with hyperkalemia.

There should be input from experienced seniors including the intensive care team for severe hyperkalemia and renal physicians for renal impairment.

of serum potassium levels below 6.5 millimoles per liter without ECG changes is aimed at

treating the underlying cause for example treating acute kidney injury and stopping causative medications for example spironolactone or ACE inhibitors.

Patients require urgent treatment for hyperkalemia to bring the potassium level down if

they have either ECG changes or a serum potassium level above 6.5 millimoles per liter.

The mainstay of treatment is with an insulin and dextrose infusion and IV calcium gluconate.

These are the two treatments to remember for hyperkalemia.

Insulin drives potassium from the extracellular space, which is the space in the body outside the cells, including the blood, to the intracellular space.

So it takes potassium out of the blood and into the cells.

Dextrose is required alongside the insulin to prevent hypoglycemia, which is a low glucose level caused by the insulin taking glucose out of the blood.

Calcium gluconate stabilizes the cardiac muscle cells and reduces the risk of arrhythmias.

Other options for lowering the serum potassium are nebulized salbutamol, which temporarily drives potassium into cells.

Oral calcium rhizonium, which reduces potassium absorption in the gastrointestinal tract, but this is slow and it causes quite bad constipation.

Sodium bicarbonate in acidotic patients on renal advice Drives potassium into cells as it corrects the acidosis And hemodialysis may be required in severe or persistent cases

Research has consistently shown that testing yourself after learning a topic Has a powerful effect on how long you retain that information This is known as the testing effect

Studying and then testing yourself results in longer lasting and stronger recall on that information when tested at a later date

Even when compared with additional study sessions If you're preparing for a medical exam and you're not regularly testing your knowledge and practicing your recall You're failing to maximize your potential

The Zero to Finals member site contains flashcards, short answer questions,

multiple choice questions and extended matching questions that are purpose built to supplement the Zero to Finals content helping you build your internal database of knowledge and take advantage of the powerful testing effect.

If you like the Zero to Finals notes, books, videos and podcasts then you'll love the member site.

शैडोइंग तकनीक क्या है?

शैडोइंग (Shadowing) एक विज्ञान-समर्थित भाषा सीखने की तकनीक है जो मूल रूप से पेशेवर दुभाषिया प्रशिक्षण के लिए विकसित की गई थी। विधि सरल लेकिन शक्तिशाली है: आप मूल अंग्रेज़ी ऑडियो सुनते हैं और तुरंत इसे ज़ोर से दोहराते हैं — जैसे वक्ता की छाया 1-2 सेकंड की देरी से। शोध से पता चलता है कि यह उच्चारण सटीकता, स्वर, लय, जुड़ी हुई ध्वनियाँ, सुनने की समझ और बोलने की प्रवाहशीलता में काफ़ी सुधार करता है।

शैडोइंग अभ्यास: Understanding Hyperkalaemia (High Potassium) - वीडियो के साथ अंग्रेजी बोलना सीखें

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