RT Journal Article SR Electronic T1 Problem solving in clinical practice: the sick infant with low sodium and high potassium JF Archives of disease in childhood - Education & practice edition JO Arch Dis Child Educ Pract Ed FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health SP 23 OP 27 DO 10.1136/archdischild-2019-317756 VO 106 IS 1 A1 Yincent Tse A1 Nidhi Singhal A1 Leigh McDonald A1 Milan Gopal A1 Anupam Lall A1 Helen Johnstone A1 Timothy Cheetham YR 2021 UL http://ep.bmj.com/content/106/1/23.abstract AB Many paediatricians will be faced with a sick infant who on investigation is found to have hyponatraemia and hyperkalaemia at some time in their career. The focus of initial management includes the treatment of potentially life-threatening hyperkalaemia with concurrent investigation aiming to elucidate whether the underlying cause reflects a primarily renal or endocrine pathology. We describe the presentation of two infants who each presented with one of the more common underlying diagnoses that led to this biochemical disturbance and discuss the approach to immediate treatment, diagnostic work-up and longer term management.