The Question is from neet-botany biotechnology , and it was created by the author NISHANTH

Question

A patient with chronic kidney disease on hemodialysis develops severe muscle cramps and weakness.  ECG shows prolonged QT interval.  Which electrolyte abnormality is MOST likely responsible for these findings?

NISHANTH · Accepted Answer

## CORE INFORMATION
✓ **Answer**: A
## CONCEPT FRAMEWORK
	**Primary Concept**: Electrolyte imbalances and their effects on neuromuscular and cardiac function in chronic kidney disease.
	**Related Topics**: Chronic kidney disease, hemodialysis, electrolyte disturbances, ECG interpretation.
	**Prerequisites**: Basic understanding of electrolyte physiology and ECG.
## SOLUTION PATHWAY
**Given Information**: 
		Patient with chronic kidney disease on hemodialysis.
		Presenting symptoms: Severe muscle cramps and weakness.
		ECG finding: Prolonged QT interval.
**Method & Steps**: 
	1. Analyze symptoms: Muscle cramps and weakness are common symptoms of hypocalcemia.
		Reasoning: Calcium plays a crucial role in muscle contraction. Low calcium levels increase neuromuscular excitability, leading to cramps and weakness. 
		Formula/Rule: None
	2. Interpret ECG findings: A prolonged QT interval can be a manifestation of hypocalcemia.
		Working: Hypocalcemia prolongs the plateau phase of the cardiac action potential, resulting in a longer QT interval.
		Key Point: Other electrolyte imbalances can also affect the QT interval, but in the context of chronic kidney disease and the given symptoms, hypocalcemia is the most likely culprit.
	3. Consider the patient's condition: Patients with chronic kidney disease on hemodialysis are at risk of hypocalcemia.
		Result: Hypocalcemia is the most likely electrolyte abnormality responsible for the patient's findings.
		Verification: The symptoms and ECG findings are consistent with hypocalcemia. Chronic kidney disease patients on hemodialysis are prone to hypocalcemia due to impaired vitamin D metabolism and phosphate retention.
 ## OPTION ANALYSIS
[A] ✓: Hypocalcemia causes increased neuromuscular excitability, leading to muscle cramps and weakness. It also prolongs the QT interval on ECG. This aligns with the patient's presentation.
[B] :x: Hyperkalemia can cause muscle weakness but typically causes peaked T waves and shortened QT intervals on ECG, not prolonged QT intervals.
[C] :x: Hypokalemia can cause muscle weakness and cramps, but it typically causes flattened T waves, U waves, and ST depression on ECG. It can prolong the QT interval, but it is less likely than hypocalcemia in this context.
[D] :x: Hypermagnesemia can cause muscle weakness and decreased deep tendon reflexes but is less likely to cause muscle cramps or a prolonged QT interval. 
 ## LEARNING AIDS
	**Common Mistakes**:
		1. Focusing solely on the ECG finding and not considering the patient's symptoms and underlying condition.: Always correlate ECG findings with the clinical picture.
		2. Confusing the ECG changes associated with different electrolyte imbalances.: Review the characteristic ECG changes for each electrolyte abnormality.
	**Quick Tips**:
		1. Remember the mnemonic 'CATS go numb' for hypocalcemia: Convulsions, Arrhythmias, Tetany, and Spasms/Stridor, Numbness/Paresthesias.
		2.  Chronic kidney disease patients on hemodialysis are at high risk for hypocalcemia.

NISHANTH · Answer

The correct Option is "Hypocalcemia"

NISHANTH · Answer

Hyperkalemia

NISHANTH · Answer

Hypokalemia

NISHANTH · Answer

Hypermagnesemia

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