A woman with recurrent vomiting and body cramps

Clinical introduction A 68-year-old woman with pancreatic cancer undergoing chemotherapy presented to the emergency department with a week of vomiting and body cramps. Vital signs were: BP 130/70 mm Hg; HR 80 bpm; RR 14 bpm and oxygen saturation 100% while breathing ambient air. Laboratory investigations showed normal calcium, magnesium and albumin levels; hypokalaemia level at 2.3 mmol/L (normal range 3.5–5.0 mmol/L) and bicarbonate level at 42 mmol/L (normal range 22–29 mmol/L). While the nurse was taking vital signs, the patient complained of a right hand cramp (figures 1 and 2) which disappeared after a few minutes. Question What is the most likely diagnosis?Parkinson disease Stroke Hyperventilation Trousseau's sign secondary to hypocalcaemia Trousseau's sign secondary to metabolic alkalosis For the answer see page 968 From the question on page 960 Answer: E Trousseau's sign secondary to metabolic alkalosis Trousseau’s sign,1...
Source: Emergency Medicine Journal - Category: Emergency Medicine Authors: Tags: Pancreas and biliary tract, EMJ Image Challenge, Stroke, Ethics Source Type: research