Electrolyte disturbances Quiz: Ace Your Exams
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A 67-year-old man with a history of hypertension and congestive heart failure presents to the primary care physician with muscle cramps, weakness, and fatigue. The patient has had multiple admissions to the hospital over the past several months and has been on escalating doses of bumetanide and hydrochlorothiazide. He was recently ill with food poisoning. Temperature is 37.0°C (98.6°F), pulse is 92/min, respirations are 16/min, blood pressure is 143/74 mmHg, and O2 saturation is 96% on room air. On physical exam the patient is not in acute distress, has 1+ peripheral edema in the lower extremities bilaterally, and has faint bibasilar rales. ECG is demonstrated below:

Image reproduced from Wikimedia Commons
Which of the following is the most likely etiology of this patient’s symptoms?

Image reproduced from Wikimedia Commons
Which of the following is the most likely etiology of this patient’s symptoms?
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