A 76-year-old patient presents to their GP with muscle weakness. He has a history of hypertension, type 2 diabetes, and heart failure. He has been prescribed indapamide on top of his normal medications due to his poorly controlled hypertension. His recent urea and electrolyte blood results are shown below:
| K+ | 3 mmol/L | (3.5 – 5.0) |
|---|---|---|
| Bicarbonate | 26 mmol/L | (22 – 29) |
| Urea | 4 mmol/L | (2.0 – 7.0) |
| Na+ | 138 mmol/L | (135 – 145) |
| Creatinine | 90 µmol/L | (55 – 120) |
What is the most likely cause of this patient’s recent urea and electrolyte blood result?
A. Decreased sodium reabsorption in the loop of Henle
B. Decreased re-absorption of sodium and water in the proximal convoluted tubule
C. Increased re-absorption of sodium bicarbonate and water in the proximal convoluted tubule
D. Increased sodium re-absorption in the loop of Henle
E. Decreased sodium re-absorption in the distal convoluted tubule
A 60-year-old patient presents with complaints of ankle swelling, shortness of breath, and mild abdominal discomfort. On examination, the physician notices ankle oedema, hepatomegaly, and jugular venous distension. An echocardiogram reveals right ventricular enlargement and tricuspid regurgitation. What condition is most consistent with these findings?
A. Generalised Anxiety Disorder
B. Gastroesophageal Reflux Disease (GERD)
C. Right Heart Failure
D. Chronic Kidney Disease
E. Hyperalbuminaemia
Select the false statement regarding the causes and/or the effects of electrolyte disturbances in the body.
A. Administration of insulin can lead to lower serum potassium levels
B. Metabolic acidosis and muscle cramps can be accompanied with hyperkalaemia
C. Addison’s disease can cause hypernatraemia due to the decreased renal elimination of sodium in the state of hypoaldosteronism
D. Patients taking loop diuretics have a greater risk of hypokalaemia
E. U wave can be seen in the ECG of hypokalaemic patients
A 58-year-old woman presents to their GP with breathlessness. During history-taking, GP also notes fatigue and lethargy that has been going on for the past year. Moreover, she reports experiencing tingling sensations and numbness in her hands. On examination, the GP notices glossitis as well as jaundice in her skin. Given her presentation what is the most likely diagnosis?
A. Iron deficiency anaemia
B. Pernicious anaemia
C. Chronic alcoholism
D. Anaemia of chronic disease
E. Folate deficiency