21st May 2025

You are asked to see a 78-year-old lady who has become confused and the nurses report she has developed weakness in her limbs and dysphagia.

You are asked to see a 78-year-old lady who has become confused and the nurses report she has developed weakness in her limbs and dysphagia. Looking back through her notes you notice that 2 days ago she was profoundly hyponatraemic with a sodium of 118 mmol/L. She was given fast IVF and slow sodium and you note that today her sodium is 134 mmol/L. This lady’s medications include slow sodium, tazocin and aspirin.

Which of the following are the most likely cause of this lady’s symptoms? Please select only ONE answer.