A 58-year-old man presents to the ED complaining of generalized weakness for the last 2 days. He states that a few days ago he had abdominal cramps, vomiting, and diarrhea when his whole family got sick after a picnic. These symptoms resolved a day and a half ago but he has not been eating well and now feels weak all over. The patient has a history of hypertension for which he takes hydrochlorothiazide (HCTZ), which was recently increased. His BP is 144/87 mm Hg, HR is 89 beats per minute, temperature is 98.7°F, and RR is 12 breaths per minute. The physical examination reveals hyporeflexia. His electrocardiogram (ECG) is shown below. Which of the following is the most likely diagnosis? A) Hypernatremia B) Hyponatremia C) Hyperkalemia D) Hypokalemia E) Hypercalcemia

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I agree with Dr shivraj sir it's appearing as hyponatremia as symptoms like vomiting and diarrhea leads to hyponatremia and also hyporeflexia also there

D) Hypokalemia

Thanks Dr Sanjoy Sarkar
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Ans - D Agree@Dr. Sanjoy Sarkar @Dr. Ashok Leel

Prolonged PR interval, prominent P wave, ST depression ( down up) and U wave. D.

Frequent u waves noted Answer is D hypokalaemia

Thanks Dr Dr G Chaudhary
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SUGGESTIVE OF... D... HYPOKALAEMIA

Hypokalemia . Doctor S.L. Gupta

D, prominent u waves

D hypokalemia

B hyponatremia

Thanx dr Afzal Baig
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