🏥 USMLE Exam Prep

A 45-year-old female presents with severe generalized weakness, muscle cramps, and palpitations. ECG shows prominent U waves and flattened T waves. Her serum potassium is 2.1 mEq/L. She is otherwise stable. Which of the following is the most appropriate initial treatment?

A Oral potassium supplementation and dietary advice.
B Intravenous potassium chloride infusion at 10 mEq/hour.
C Intravenous calcium gluconate to stabilize cardiac membranes.
D Initiate dialysis for rapid potassium correction.

✓ Correct Answer: Option B

Severe hypokalemia with ECG changes requires intravenous potassium replacement. Given the cardiac involvement, rapid, but safe, correction is needed, typically at a rate of 10-20 mEq/hour. Oral supplementation is too slow for symptomatic hypokalemia. Calcium is for hyperkalemia, and dialysis is not indicated.

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