Which electrolyte abnormality commonly causes tall, peaked T waves on the EKG and requires urgent management if hyperkalemic with ECG changes?

• A. Hypokalemia
• B. Hypermagnesemia
• C. Hyperkalemia
• D. Hyponatremia

Answer: (C)

Tall, peaked T waves on an EKG point to high potassium levels in the blood. When potassium rises, it speeds up repolarization of the ventricles, which shows up as these tall, narrow T waves. This rhythm pattern is a warning sign that the situation can deteriorate quickly into wider QRS complexes and dangerous arrhythmias, so it requires urgent treatment as soon as ECG changes are noted.

Immediate steps focus on protecting the heart first and then lowering the potassium. Start with IV calcium to stabilize the myocardium. Then shift potassium back into cells using insulin with glucose, and consider a beta-agonist such as albuterol or sodium bicarbonate if acidosis is present. After that, remove potassium from the body with options like diuretics (if kidney function is adequate), cation-exchange resins, or dialysis in severe cases or renal failure.