A 24-Year-Old Woman Is Brought to the Emergency Department Due

question 1647

Multiple Choice

A 24-year-old woman is brought to the emergency department due to feeling lightheaded every time she stands up.  The patient has no significant medical problems.  She left her boyfriend 4 months ago as he was "eating too much" and has since had decreased appetite and lost 5 kg (11 lb) .  The patient has also missed her last 2 menstrual periods.  She does not use tobacco, alcohol, or illicit drugs.  Family history is significant for coronary artery disease and congestive heart failure.  Her temperature is 36.7 C (98 F) , blood pressure is 100/70 mm Hg, and pulse is 88/min while supine.  On standing, blood pressure is 80/55 mm Hg and pulse is 120/min.  Other than dry skin and mucous membranes, the patient's physical examination is unremarkable.  Initial laboratory results are as follows: Which of the following is the most likely underlying etiology for this patient's symptoms?

• A)Cerebral salt wasting
• B)Diuretic abuse
• C)Laxative abuse
• D)Low caloric intake
• E)Mineralocorticoid deficiency
• F)Self-induced vomiting

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Definitions:

Vacation Time

A period of time allocated for rest, travel, or recreation, often away from one's regular work or school environment.

Groove

A term that can refer to a musical rhythm that feels particularly compelling or to a long, narrow cut or depression in a surface.

Exercise

Physical activities intended to improve strength and fitness.

Homework Assignments

Tasks assigned to students by their teachers to complete outside of class time, intended to reinforce lessons learned in the classroom.