31st January 2024

You are asked to see an 18-year-old young woman called Sarah who has been referred to the medical assessment unit by her GP for hypokalaemia of 2.8mmol/L, with a raised urea of 10mmol/L and a creatine, which is within normal limits but raised compared to a result from 2 years ago.

You are asked to see an 18-year-old young woman called Sarah who has been referred to the medical assessment unit by her GP for hypokalaemia of 2.8mmol/L, with a raised urea of 10mmol/L and a creatine, which is within normal limits but raised compared to a result from 2 years ago. The GP had conducted these blood tests as Sarah returned home from university for the Christmas break, and her mum noticed that she hadn’t been finishing her meals and looked thinner than before leaving for university in September. Sarah does not believe she has a problem but wants to get her mum “off her back.” Sarah gives little history and lots of “I don’t know” when asking about her intake, but she denies bingeing and other than appearing quite thin, her physical examination is unremarkable. She refuses to be weighed, but GP records indicate she used to be overweight.

What is the most likely diagnosis?

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