Case 45: Introduction

Case submitted by: Dr. Jamie Willows
Published: July 2020

History of Present Illness (HPI)


A 36 year-old woman with a past medical history of irritable bowel syndrome (IBS) and gastroesophageal reflux disease (GERD) was referred to your clinic – she tells you she has been told she has a “potassium problem.”

She first heard about this five years ago when she was worked up for abdominal pain.  She has been on and off both potassium and magnesium supplements periodically from her primary care doctor since then.

She often feels tired. She was a full-time teacher and now can only work part-time due to fatigue.  She experiences frequent muscle cramps, especially at night.  She has not had any weakness, extremity tingling or numbness, dry mouth or palpitations, and has not experienced seizure, or arrhythmia.  She has not had vomiting or diarrhea.  She describes her diet as “healthy”, though admits she likes to add a lot of salt to her food.

She has taken omeprazole 40 mg daily  for one year, and oral electrolytes replacement when advised. She does take any over the counter medications or use illicit drugs.  She has no family history of kidney disease or hypertension.

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