<prompt> Pseudo P Pulmonale seen inHypokalemiaHyperkalemiaHypomagnesemiaHypercalcemia  <response>: Ans. a. HypokalemiaRef: Oxford Handbook of Clinical Medicine; Page No-90P WAVENormally precedes each QRS complex and upright in II, III and aVF but inverted in aVR.Absent P wave: AF, Sinoatrial block, Junctional AV nodal rhythm.Complete heart block indicates; dissociation between P waves and QRS complex.P. mitrale: Bifid P wave, it indicates left arterial hypertrophy.P. Pulmonale: Peaked P wave, it indicates right atrial hypertrophy.Pseudo P. Pulmonale seen if K decreases.ELECTROCARDIOGRAPHIC FINDINGS IN ELECTROLYTE DISTURBANCESHypokalemia related with ECGHyperkalemia related with ECG. U and T wave fuse. Increased QRS amplitude. Increased QRS duration. Increased P wave amplitude,. Increased P wave duration. ST segment depression. PR interval slightly prolonged. T wave inversion. Prominent U waves. Long QU intervalMild Hyperkalemia. P wave Normal. QRS Normal. T wave: Tall and tented, often symmetric with narrow base; usually best seen in leads II. Ill, V2 and V4. The corrected QT interval not prolongedSevere Hyperkalemia. P wave: Amplitude decreases, duration increases until it eventually disappears. QRS: Broadens, wide S waves in the left precordial leads. QRS axis: Superior left axis deviation.. ST segment: The terminal S waves become continuous with the tall tented T wave ECG changes in HypocalcaemiaECG Changes in Hypercalcaemia. Hypocalcaemia causes QTc prolongation primarily by prolonging the ST segment. The T wave is typically left unchanged. Dysrhythmias are uncommon, although atrial fibrillation has been reported.. Torsades de pointes may occur, but is much less common than with hypokalaemia or hypomagnesaemia. The main ECG abnormality seen with hypercalcaemia is shortening of the QT interval. In severe hypercalcaemia, Osborn waves J waves may be seen. Ventricular irritability and VF arrest has been reported with extreme hypercalcaemia ECG changes in HypomagnesaemiaECG changes in Hypermagnesaemia. The primary ECG abnormality seen with hypomagnesaemia is a prolonged QTc. Atrial and ventricular ectopy, atrial tachyarrhythmias and torsades de pointes are seen in the context of hypomagnesaemia. Tall T wave. Depressed ST segment. Prolonged PR interval. Widened QRS complex 