Question

An elderly patient came in to the Emergency Room with nausea and vomiting, assessing physician noticed a decreased respiration, hypotension, and a low pulse rate of 46 bpm. Care taker also pointed out that the patient's skin was flushed and warm to the touch and wanted to know what the temperature was.

Serum:

Total protein 5.6 g/dL (6.0-8.0 g/dL)

Albumin 3.0 g/dl (3.5-5.0 g/dL)

Calcium 8.2 mg/dL (8.6-10.0 g/dL)

BUN 45 mg/dL (5-20 mg/dL)

Creatinine 2.3 mg/dL (0.7-1.5 mg/dL)

Magnesium 4.0 mmol/L (0.63-1.0 mmol/L)

Plasma:

Sodium 129 mmol/L (136-145 mmol/L)

Potassium 5.3 mmol/L (3.4-5.0 mmol/L)

Chloride 96 mmol/L (98-107 mmol/L)

Bicarbonate 16 mmol/L (22-29 mmol/L)

1. What is the most likely cause for the patient's symptoms?

2. What is the most likely cause for the hypermagnesemia?

3. What could be the cause for the hypokalemia?

Answer 1

1. What is the most likely cause for the patient's symptoms?

It is clearly evident from his signs and symptoms as well as lab results that the patient is suffering from renal failure

.2. What is the most likely cause for the hypermagnesemia?

Magnesium iss usually excreted by our kidneys. Any damage to the kidneys or if it is not working properly may cause an increase in magnesium levels.

Other reasons for hypermagnesemia incude

• Increased destruction or shift of the potassium from within the cells.
• Decreased excretion of potassium from the body
• Too much of magnesium content in our diet

3. What could be the cause for the hypokalemia?

• Chronic kidney disease
• Diabetic ketoacidosis
• Diarrhea
• Excessive laxative use
• Hyperhidrosis disorder
• Folic acid deficency