A 26 year old woman presents to the ER with generalized weakness associated with perioral numbness. She is moderately built and looks slightly depressed. On physical exam, she has mild pallor. She denies use of any medications. BP 120/88 mmHg and physical exam is normal. Lab data: Cr 1.2mg/dL, BUN 15mg/dLNa 136 , K 2.8 , Cl 88 , HCO3 38. Urine Na 45 meq/L, Urine K 35 meq/L, Urine Cl 8 meq/L, Urine specific gravity 1.010, Urine pH 7.
Most likely diagnosis is :
A)Laxative Abuse
B)Surreptious vomiting
C)Licorice abuse
D)Malabsorption Syndrome
E)Hyporeninemic Hypoaldosteronism
q21) Most appropriate next step in the management:
A)IV normal saline
B)Spronolactone
C)Amiloride
D)Psychiatry consult
E)Reassurance because this is self limiting beca
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