Approach to hypernatremia Quiz: Ace Your Exams

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A 55-year-old woman presents to the primary care office for evaluation of persistent hypertension. She has been trialed on several medications without notable change in blood pressure. The patient has also been experiencing persistent weakness, muscle cramps, and fatigue. There is no other significant past medical history aside from hypertension. Medications include amlodipine, hydrochlorothiazide, and lisinopril. Temperature is 37°C (98.6°F), blood pressure is 166/84 mmHg, heart rate is 77 beats per minute, respiratory rate is 16 breaths per minute, and oxygen saturation is 99% on room air. On physical examination, the patient is in no acute distress. Cardiopulmonary and abdominal examinations are within normal limits. Pitting edema is noted to the lower extremities bilaterally. Laboratory studies are detailed below. Which of the following additional results would be expected?  

 Laboratory value Result
 Serum chemistry
 Sodium 148 mEq/L
 Potassium 2.9 mEq/L
 Chloride 97 mEq/L
 Creatinine 1.0 mg/dL

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