A 58-year-old woman shows signs of fatigue, diarrhea, and skin changes. What is the most likely electrolyte abnormality?

The scenario describes a 58-year-old woman with fatigue, diarrhea, and skin changes, which suggests an underlying condition that could be impacting electrolyte levels. In particular, the symptoms of fatigue and diarrhea can lead to significant losses of electrolytes, especially potassium.

The chosen option indicates sodium at 120mmol/L and potassium at 5.9mmol/L. A sodium level of 120mmol/L indicates hyponatremia, which can result from excess fluid losses due to diarrhea, impacting the concentration of sodium in the serum. Additionally, the potassium level is notably elevated (hyperkalemia) at 5.9mmol/L. This is a critical point because the loss of potassium from the body often occurs through gastrointestinal routes, but in the presence of renal dysfunction (which may not be described explicitly in the scenario), the potassium levels can rise significantly.

Elevated potassium can result from various mechanisms, including renal failure or adrenal insufficiency, both of which could coexist with gastrointestinal losses. The combination of hyponatremia and hyperkalemia in this context aligns with conditions such as adrenal insufficiency or other syndromes, where aldosterone secretion is inadequate, leading to decreased sodium reabsorption and potassium secretion.

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