Case Published: January 2019

History of Present Illness (HPI)

A 69 year old woman with a history of  hypothyroidism and hypertension presents to the emergency department with complaints of fatigue and weakness for the last several weeks. Before that, she had been feeling well. She reports intermittent headaches that seem to respond to acetaminophen as well as a 10 pound weight loss and night sweats. She has not had nausea, vomiting, chest pain, shortness of breath, abdominal pain, diarrhea, or swelling of her extremities. She has been urinating normally and does not have any dysuria or hematuria.

She lives at home with her 2 dogs and has 2 alcoholic drinks per week. She does not smoke tobacco or use illicit drugs. She is a high school teacher.

Her medications are levothyroxine 75 mcg daily and acetaminophen 325 mg as needed for pain.

You are called by the emergency department shortly after the patient arrives for an elevated potassium level.

Click here for the physical exam!