31st January 2024

You are a medical SHO on an acute medical unit.

You are a medical SHO on an acute medical unit. You are asked to see a 25-year-old woman who has been advised to attend following their assessment appointment with a psychiatrist. They report vomiting once a day for the past 8 months, in a cycle of restricting eating all day, bingeing on food after coming home from work and induced vomiting due to feelings of guilt and shame. She denies laxative use. On examination, the only finding is Russell’s sign positive.

What is the most likely electrolyte abnormality?

Select the SINGLE most appropriate option from the list below. Select ONE option only.