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 Best of Five 2.33

 

   

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BOF 2.33

A 26-year-old female presents with abdominal pain, nausea and vomiting and constipation. She complains of discolouration of her urine. There is a previous history of epilepsy. On examination she is in pain, pulse rate of 120 beats per minute, BP 160/90 abdomen soft not distended, no lumps or tender areas, bowel sounds normal.

Investigations reveal:

Hb12.5 g/dL

White cell count 5.5 x 10 9 /L

Neutrophils 3.5 x 10 9 /L

Lymphocytes 1.5 x 10 9 /L

Monocytes 0.7 x 10 9 /L

Eosinophils 0.3 x 10 9 /L

Na 120 mmol/L

K 4.0 mmol/L

Urea 3.0 mmol/L

Serum creatinine 75 mmol/L

Your initial management of this patient would be:

a)      Low carbohydrate diet

b)      High protein diet

c)      Infusion of haem arginate in dilute albumin solution through a peripheral vein

d)      Infusion of haem arginate through a central vein

e)      Infusion of tin porphyrin

 

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