Hyperkalemia Explained Clearly - Fluid and Electrolyte Imbalances

Dr. Seheult illustrates key hyperkalemia causes, pathophysiology, EKG/ECG changes (including peaked T waves) and potential arrhythmias.
This is video 1 of 2 on hyperkalemia (high potassium). Video 2 discusses hyperkalemia treatment.
Speaker: Roger Seheult, MD
Clinical and Exam Preparation Instructor
Board Certified in Internal Medicine, Pulmonary Disease, Critical Care, and Sleep Medicine.
Website - www.medcram.com/?Y...
MedCram: Medical topics explained clearly including: Asthma, COPD, Acute Renal Failure, Mechanical Ventilation, Oxygen Hemoglobin Dissociation Curve, Hypertension, Shock, Diabetic Ketoacidosis (DKA), Medical Acid Base, VQ Mismatch, Hyponatremia, Liver Function Tests, Pulmonary Function Tests (PFTs), Adrenal Gland, Pneumonia Treatment, any many others. New topics are often added weekly- please subscribe to help support MedCram and become notified when new videos have been uploaded.
Subscribe: kzbin.info_...
Recommended Audience: Health care professionals and medical students: including physicians, nurse practitioners, physician assistants, nurses, respiratory therapists, EMT and paramedics, and many others. Review for USMLE, MCAT, PANCE, NCLEX, NAPLEX, NDBE, RN, RT, MD, DO, PA, NP school and board examinations.
More from MedCram:
Complete Video library: / medcram
Facebook: / medcram
Google+: plus.google.com/u/1/+Medcram
Twitter: / medcramvideos
Produced by Kyle Allred PA-C
Please note: MedCram medical videos, medical lectures, medical illustrations, and medical animations are for medical educational and exam preparation purposes, and not intended to replace recommendations by your health care provider.

[@josephquinto5812]

This is how my father died today. He has been dealing with kidney failure and simply refused to do his peritoneal dialysis treatment. He did not want to live anymore due to all of the pain it caused him. He was very delirious, weak, tired and cold throughout the ordeal. He went into cardiac arrest in the ambulance and died upon arrival to the hospital. High potassium is deadly and anyone dealing with hyperkalemia should take it very seriously.

[@Medcram]

See the whole series at www.medcram.com along with other top quality videos including reviews in pulmonary, cardiology, infectious disease, and hematology!

[@lynncoffin180]

My issue is: Why aren't we warned earlier than Stage 3 that our potassium is inching up each time we have lab work? Many patients in my support group are VERY angry that we aren't notified as soon as any increase in potassium, phosphorous, A1c, etc., shows an ongoing increase even if a little bit. All they ever warn us about is B/P and want to prescribe statins. No mention of anything else.

[@obinnambachu7631]

thanks for posting these! very helpful in anesthesia applications!

[@wvllanner4]

We had this topic last Spring and this video was a great refresher. Thank you!

[@Medcram]

wvllanner4 Good to hear- thank you

[@peg5gy]

Clear, interesting and easy to follow....Thank You!

[@Splak9]

Thank you so much !!! I would love if you completed the series with Hypokalemia !! Thanks Again !!!

[@megaroozi2200]

Cushing’s was an error, he meant Addison’s disease. Thank you for your video.

[@Medcram]

+megaroozi correct Addisons is the disease when the adrenal gland is less secretory not Cushings

[@gabrielfranco8687]

Great Lecture !!! Thank you

[@matriwedding]

It really is explained clearly! Thanks

[@susanrodriguez8297]

Thank you Dr. Seheult.

[@Elixir.dm.]

Thank you medcram

[@marcialbonifacio3285]

Thank you for the video, very informative

[@amaranathl9864]

exteremly good and simple to understand thanks

[@rizabalwenardgabrille7429]

I discovered another helpful channel

[@Jay-wv1xu]

Sooooo helpful!! Thank you 😊

[@Unojoservir]

Could you please unlock the treatment video? It’s currently listed as private. Thank you

[@crhaefner]

Great video! I was a little confused at the end, does hyperkalemia result in the heart cell being more easily depolarized or more difficult to depolarize?

[@navidaliaghai78]

excellent videos. you do indeed explain things clearly. This is great review for a practicing RN.

[@Medcram]

+Navid Aliaghai Good to hear- thanks so much for the comment

[@adelaidechamille9673]

Thanks a lot a great explanation

[@emmanuelfombu4902]

excellent video

[@JohnSmith-hl8zy]

Can you please complete this series by adding Hypokalemia? Thank You!

[@lorib5398]

I see how this works. A loss leader video to buy video 2 on the websight.

[@haydeepadua7549]

I am a student here in the Philippines.. thanks for this video.. it helps me a lot for my discussion..

[@Medcram]

Thanks for watching in the Philippines. Best wishes with your studies and thanks for the comment

[@abdelhamidbenzerroug5651]

I am a student and your videos help me. All your videos are so clear and interesting !! Thank you so much !!

[@Medcram]

+Abdelhamid Benzerroug Thank you for the feedback

[@rudolfhuijs4526]

Thanks Dr. Seheult. Explained clearly. Could you make some video about magnesium, another essential element for our body.

[@somasoma5903]

Thanks that's what i was looking for 😊😊

[@Medcram]

:)

[@zeb644]

Thank you so much 😭

[@ElMedico408]

What happened to the treatment video of Hyper K?? There was a video explaining treatment interactions at a physiological level.

[@vbt1992]

Thanks for Good Explanation :) So with Hyperkalemia will become more Depolarized at RMP?

[@cardiospecial]

Can you explain how the narrow and peak T wave happen?

[@ayamTondoBoy]

I would add rapid infusion or overdosing of IV Potassium as a cause of hyperkalemia. Thank you for the video!

[@anete_g]

Thanks, this is a tricky subject :)

[@Medcram]

Anete Libeka Glad the video helped

[@charleslangdonbostonphilad765]

+MEDCRAMvideos thanks man could u explain why hyponatremia,hypoglycemia and metabolic acidosis occur in adrenal failure

[@amineaboutalib]

all hydroelectrolytes disorders basically

[@romeolhk1008]

Excellent video! But still I have a question. At 11:03, did you mention the membrane excitability will DECREASE? If hyperkalemia elevated the baseline potential, shouldn't the excitability be INCREASED? Thankyou.

[@kumaradarsh3983]

Increased potassium levels cause a sustained increase in membrane potential and it becomes less negative. One would expect that this would make depolarization easier and the cell hyperexcitable BUT actually sustained increase in membrane potential closes the deactivation gate of sodium channels and this prevents sodium influx and action potential cannot be generated. This is called ACCOMMODATION.

[@anujtaparia1255]

Can you do a lecture on hypokalemia?

[@cutiepiezapzap4369]

Thank you T_T

[@randajamesjosephnoel7087]

Great explanation 👌🏽

[@Medcram]

Glad it was helpful!

[@brianthomas1531]

Amazing videos!! Can you touch on some of the other electrolytes. Na+, calcium, magnesium etc. That would be very helpful.

[@gunaletchu6071]

Thanks

[@umarchaudhry8953]

Great lecture but I have a pressing question, can you please tell me the name of the song that is at the end. :)

[@aaatsportinggoods7623]

How does a less negative resting potential cause a spike T wave though? there should be less electrical potential to drive a large influx of K.

[@dublinbluetune]

Watch at 1.5 speed... you're welcome

[@naturallawhealth9272]

Other than Angiotensin II and adrenocorticotropic hormone, what else triggers the adrenal gland to secrete mineralocorticoids? I didn't even think adrenocorticotropic hormone did this, I thought it only stimulated the release of cortisol. Please explain thank you

[@entisarsaleh6]

thank you , I suggest to have a lecture on action potential and anti arrythmics , thanks again .

[@Medcram]

+‫رصاصة الرحمة‬‎ Thank you for the topic suggestion

[@ranbunnarong8232]

Can you explain clearly on the point why hyperkalimia can make depolarization late than normal?

[@About36Greekss]

What about a burning left arm ? Going to the doctors soon but I’ve had this for about 3 weeks while on keto . I think it’s from high potassium

[@Potaetis]

At 5:44, you write "adrenal failure (Cushings Disease)". I think it should be Addisons disease? To my knowledge, Cushings is the opposite to adrenal failure; the cortices are hyperactive, leading to high levels of cortisol and aldosterone, which in turn leads to hypOkalemia, not hyper.

[@minniesupnet1105]

Hyperkalemia simplified!!

[@ronnorris6685]

At 12:20 I think you meant to say Addison's disease. Thanks for your videos.

[@Medcram]

Ron Norris Thanks for catching this- you are correct. I've made a note on the video that I should have wrote Addison's.

[@vanessanichols8369]

You also get an absent p wave right?

[@mirandati1995]

Do you have a video on hypokalemia too?

[@Medcram]

+miranda ti Not yet...

[@gabyjimenez961]

is there any of hypokalemia?

[@alsh123am3]

But why do we have a high and fast repolarisation if the extracellular K+ -Concentration is already so high?? I thought also repolarisation will happen very slowly?

[@Ani.DR.07]

alsh123am yes same question here.#Medcram plz solve it @medcrAm

[@dp7957]

One of the potassium currents (Ikr), located on the myocyte cell membrane, is mostly responsible for the potassium efflux seen during phases 2 and 3 of the cardiac action potential.10 For reasons that are not well understood, these Ikr currents are sensitive to extracellular potassium levels, and as the potassium levels increase in the extracellular space, potassium conductance through these currents is increased so that more potassium leaves the myocyte in any given time period.10 This leads to an increase in the slope of phases 2 and 3 of the action potential in patients with hyperkalemia and therefore, to a shortening of the repolarization time. This is thought to be the mechanism responsible for some of the early electrocardiographic manifestations of hyperkalemia, such as ST-T segment depression, peaked T waves, and Q-T interval shortening from: www.ncbi.nlm.nih.gov/pmc/articles/PMC1413606/

[@HafizahHoshni]

Very informative! Thank you so much! 😃😃 27/2/2019

[@mirandati1995]

Why there is a hyperpolarization due to inactivated sodium channels, thanks

[@inyeneakpan3612]

@miranda ti please did you get a reply, I'm stucked here too

[@vshanthikala8806]

Is cushing disease causes hypokalemia or hyperkalemia ?

[@nadasdwiddar]

can u expalin the relationship between k level and acid base balance..... very confusing

[@Medcram]

+Nada Dwiddar yes as the blood pH goes down this causes protons in the blood to go into the cells. Potassium then comes out of the cells to balance it and this causes hyperkalemia. The opposite occurs when the blood pH goes up.

[@nadasdwiddar]

MedCram - Medical Lectures Explained CLEARLY thank you very much..... 😊😊

[@anaszain6491]

I think der r some errors here.. Firstly..tendency to depolarise increases initially bcz K conc outside the cell becomes high nd hence its difficult fr K to leave the cell nd hence the polarity inside bcmz more postve nd towrds the threshold potential..bt then free flow of Na should happen and it wont happen bcz f increased postve charge inside the cell..this will actually delay the depolarisation.Now during the repolarisation, initially der s a plateau phase where K efflux and Ca influx happens simultaneously..but since K does not leave as easily as expected bcz f reduced gradient,there will be prolongation in the repolarisation which is evident from the delayed or wide QRS..Eventually leading to absent atrial depolarisation and sine wave pattern nd ventricle fires at its own rate and produce ventricular fibrilations nd cardiac arrest @ d end evidenced by asystole in ECG

[@erlindaspaade3392]

a very informative topics

[@composedmocha47]

Adrenal failure is known as Addisons Diseases, not Cushing’s syndrome.

[@nadasdwiddar]

it is said that hyperkalaemia is often associated with metabolic acidosis.... yet the only cause in which acidosis and hyperkalaemia occur is addison's disease. other causes of metabolic acidosis ( DKA, acetazolamide, diarrhea, and renal tubular acidosis are associated with hypokalaemia. would you like to explain that please??

[@Medcram]

+Nada Dwiddar this is because acidosis itself causes hyperkalemia. Protons in the serum go into the cell in exchange for potassium which comes out of the cell causing hyperkalemia.

[@Brozer999]

Adrenal failure is Addison disease not Cushing sir

[@MURDR63]

Dude, you sound EXACTLY like Sal Khan...unless you narrate the MCAT videos on Khan Academy?

[@ummatsyed2133]

why a grain of salt if hemolysis occurs?

[@adelagasque125]

Is 3.47 level is dangerous what to do on this level.

[@sassydesigngirl]

No thats normal

[@sapiohuntstv9392]

I’m 24 but suffering hyperkalemia rn 🥺

[@nellyhoffman6194]

But why Does acidosis cause hyperkalemia ? This remains my question :p Maybe you can clarify for us sir ?

[@hattietoodle7496]

pulmonary embolism

[@drtariqueahmad7080]

Tall tented t wave.. hyperkalemia..

[@AHMNZ]

my dad had hyperkalemia and doctors placed a pacemaker in his neck

[@ronn68]

Dialysis patients should never use salt substitute.

[@drjabahavarghese7667]

🥰

[@diwaskarkee1667]

Not so helpful.... 6/10...only

[@tiffsaver]

WAY too scientific for most viewers to understand... this sounds like a doctoral dissertation!!

[@hashimismail9901]

Can you do a lecture on hypokalemia?

[@Medcram]

+Hashim Ismail Thanks for the suggestion

[@evasmiljanic3529]

seconded

[@carvchlo]

We are waiting :) Thanks so much!

[@TheGreatSniper]

Preferably before my nephrology exam on the 31st of August, please :P

[@nellyhoffman6194]

PLease did you do it ?