Background: Hospitalists routinely precept third year medical students on general internal medicine wards. One of the key patient care tasks for students is to interpret and initiate management for common electrolyte abnormalities. Formal training to achieve this is lacking for students transitioning from preclinical to clinical years. We designed and implemented a module on interpreting […]

Background: In the inpatient setting, serum potassium (K) and magnesium (Mg) are frequently replaced for patients with values within the reference range (generally K 3.5-5.0 mEq/L, Mg 1.3-2.2 mEq/L) to target an arbitrary goal of 4 mEq/L for K and 2 mEq/L for Mg.(1,2) For certain high-risk non-pregnant adults, K and Mg replacement to these […]

Case Presentation: A 69-year-old female presented to the Emergency Department with progressive weakness, nausea, vomiting, diarrhea, abdominal pain, and confusion for several weeks following an eye surgery the month prior, with symptoms acutely worsening over the last week. On the day of admission, she was found disoriented and clinging to a doorway at home, unable […]

Case Presentation: A 34-year-old man with hypertension on chlorthalidone and recent COVID-19 infection treated with Paxlovid presented to the ED with three days of shortness of breath, dizziness, and diarrhea. On exam, he was alert, neurologically non-focal, and underweight by BMI. Initial lab work was significant for severe hyponatremia (< 100 mmol/L) and hypokalemia (2.3 […]

Case Presentation: A 26-year-old male with no significant past medical history was intubated due to respiratory failure from cocaine and fentanyl overdose. Admission labs showed severe rhabdomyolysis (creatinine kinase> 22K U/L), hyperphosphatemia (>20mg/dL) and hyperkalemia (>10mmol/L) with creatinine 2.9mg/dL. ICU course was complicated by hypoalbuminemia, chronic hypocalcemia (corrected calcium-7.6-8.4 mmol/L) and chronic hyperphosphatemia (5.6-10mg/dL). He […]