Case Published: July 2018

History of Present Illness (HPI)

A 60-year-old woman with past medical history of multiple myeloma and hypertension is admitted to the medicine service for an abnormal lab value after a recent admission for cord compression that required surgical intervention. She reports poor intake at home and intermittent nausea, but denies fever, headache, chest pain, abdominal pain, diarrhea, urinary symptoms, or extremity pain or swelling.

Her multiple myeloma history is notable for treatment within the past week with cisplatin, cyclophosphamide, and etoposide. She was also recently started on oral dexamethasone for her cord compression.

Her other current medications include nifedipine and fluoxetine (selective serotonin reuptake inhibitor.

You are called for a serum sodium level of 120 meq/L, that was 137 meq/L 5 days ago.

Click here for the physical exam!