A 49-Year-Old Alcoholic Man Is Admitted for Diarrhea and Generalized

question 642

Multiple Choice

A 49-year-old alcoholic man is admitted for diarrhea and generalized abdominal pain.  His blood pressure is 134/80 mm Hg, pulse is 90/min, respirations are 16/min, and oxygen saturation is 97% on room air.  He is disheveled and looks chronically ill.  He is oriented to person and place.  His mucous membranes are dry.  His abdomen is soft and mildly tender in the epigastric region.  He has no focal neurologic findings.
An electrocardiogram and chest x-ray is unremarkable.  Stool samples are sent for culture and microscopic examination.
Laboratory results are as follows:

He is given thiamine and a multivitamin intravenously along with three liters of normal saline with 5% dextrose.  He also receives intravenous potassium and magnesium supplementation.  Thirty-six hours after admission, he complains of severe weakness.  His oxygenation has decreased and he appears agitated.
Repeat laboratory results are as follows:

Which of the following is the most likely cause of this patient's new-onset weakness?

• A)Alcohol withdrawal
• B)Hypomagnesemia
• C)Hypophosphatemia
• D)Rhabdomyolysis
• E)Wernicke's encephalopathy

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Definitions:

Monthly Payments

Regular payments made on a monthly basis towards settling a financial obligation, such as a loan or mortgage.

Effective Annual Rate

The effective annual rate is the interest rate on a financial product restated from the nominal rate as an annual rate that takes into account compounding over a given period.

Nominal Annual Rate

The interest rate stated on a loan or financial product, not accounting for compounding or inflation over time.

Interest Payments

Periodic payments made to lenders or bondholders as compensation for lending their money.