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Labs

Hypotension with the wrong electrolytes

advanced

A 47-year-old with fatigue and weight loss for months, now vomiting and dizzy after a flu-like illness. BP 84/52 despite two litres of saline. She is tanned, in November.

Results

TestAdmissionReference
Na124L135145 mmol/L
K5.9H3.55 mmol/L
Glu3.1L47.8 mmol/L
Urea12.4H2.58 mmol/L
Cr128H60110 µmol/L
HCO319L2228 mmol/L
TSH6.8H0.44 mIU/L

Refractory hypotension with LOW sodium, HIGH potassium, and low glucose. The move that saves this life?