Lethargy in Medicine / Internal Medicine — 50yo Man | Nephrology | SMLE Q#18403

SMLE Question #18403

Medicine / Internal Medicine Nephrology

Objective: OBJ-IM-NEPH-HYPERK-001

Last updated: February 2026
A 50-year-old man presents to the emergency department with lethargy. He denies chest pain, palpitations, or dyspnoea. ECG shows normal sinus rhythm without conduction abnormalities or T-wave changes. He is haemodynamically stable. Laboratory tests show potassium 6.6 mmol/L and bicarbonate 15 mmol/L with normal creatinine. What is the most appropriate initial management?

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