EMQs in Clinical Medicine.pdf - Peshawar Medical College

198 Metabolic and endocrine disturbances
80 Electrolyte and metabolic disturbances
A
B
C
D
E
F
G
hyperkalaemia
hypomagnesaemia
hyperlipidaemia
zinc deficiency
hypomanganesaemia
hypernatraemia
hyponatraemia
H
I
J
K
L
M
hypocalcaemia
selenium deficiency
hypercalcaemia
hypokalaemia
hypoglycaemia
hyperglycaemia
For each clinical scenario below, suggest the most likely electrolyte/metabolic disturbance
that is present in the patient in each question. Each option may be used
only once.
1 A 40-year-old woman treated with spironolactone and lisinopril for heart failure
presents with bradycardia. ECG shows tall, tented ‘t’ waves.
2 A 30-year-old woman presents with tetany, perioral paraesthesia and carpopedal
spasm after thyroid surgery.
3 A 30-year-old man being treated for a systemic fungal infection presents with
muscle weakness, arrhythmias and tetany. His ECG shows prolonged P–R interval
and prominent U waves.
4 A 50-year-old woman on total parenteral nutrition (TPN) presents with red
crusted lesions around the nostrils and corner of the mouth.
5 A 45-year-old woman presents with thirst, abdominal pain and history of renal
stones.
Answers: see page 205.