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An abnormality at the hepatic flexure

A 92 year old woman presented to the emergency department after collapsing at home. She recalled standing from her chair, feeling lightheaded, and then collapsing. She had felt generally weak for more than a year, with weight loss of 56 lb (25.2 kg) but no change in bowel habit, dysphagia, or gastrointestinal bleeding. Her medical history included hypertension, hypothyroidism, and anaemia (which was currently being investigated by her general practitioner). Among other drugs, she was taking lisinopril, bendroflumethiazide, and levothyroxine. Her son had died at 60 years of age from large bowel obstruction and perforation secondary to colon cancer.  
bmj.com
over 6 years ago
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15

An abnormality at the hepatic flexure

A 92 year old woman presented to the emergency department after collapsing at home. She recalled standing from her chair, feeling lightheaded, and then collapsing. She had felt generally weak for more than a year, with weight loss of 56 lb (25.2 kg) but no change in bowel habit, dysphagia, or gastrointestinal bleeding. Her medical history included hypertension, hypothyroidism, and anaemia (which was currently being investigated by her general practitioner). Among other drugs, she was taking lisinopril, bendroflumethiazide, and levothyroxine. Her son had died at 60 years of age from large bowel obstruction and perforation secondary to colon cancer.  
feeds.bmj.com
over 6 years ago
Static.www.bmj
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13

Spontaneous hypokalaemia in a man with treated hypertension

An 80 year old man with a history of hypertension, stage 3 chronic kidney disease, and paroxysmal atrial fibrillation presented feeling generally unwell and lethargic. He was taking amiodarone 200 mg, bisoprolol 10 mg, amlodipine 10 mg, and lisinopril 20 mg a day. He did not have a fever and he was haemodynamically stable. His blood pressure was controlled (132/84 mm Hg). Physical examination was unremarkable. Blood tests showed hypokalaemia (1.9 mmol/L, reference range 3.5-5.0), hypomagnesaemia (0.58 mmol/L, 0.6-1.2), and metabolic alkalosis (35 mmol/L, 20-32). His symptoms resolved after electrolyte replacement and he was discharged home.  
feeds.bmj.com
over 6 years ago