Friday, March 04, 2005

Interesting patients

A young woman was in car wreck and hit her face on the dash. She had a through and through laceration of her lower lip all the way down to the chin. She left the ER without repair at about 0430 saying that her plastic surgeon was waiting for her and that she didn't want to have a scar. What a sight she was leaving with that lac.

A 41 year old man presented with global weakness. He was unable to extend his wrists past neutral and unable to move against resistance with any extremity. Turns out his potassium was 2.8 and his phosphorus was 0.6. When these were replaced, his exam was normal. But why were they this low? Especially as his hypertension was treated with an ACE inhibitor and triamterene.

We have a lot of Bartter's syndrome in East Tennessee, but these hypokalemic people are usually asymptomatic at 2.8.