Pauline Chan

Journal Review

N4A

Med Ward

Journal # 1: A Rare Case of Hypokalemia and Hypomagnesemia: A Clinical Case Study by

Roberto Dongilli, Claudio Crivellaro, Federica Targa, Giulio Donazzan, and Markus
Herrmann
Review:
This article presents its case via an 18 year old who presented with the usual signs of
hypokalemia along with spontaneous pneumothorax with a seemingly unknown etiology.
Although his renal and other laboratory diagnostics that could indicate any physiological damage
suggested otherwise, his potassium was at a dangerously low level and his magnesium was at
borderline low. He also failed to respond to the initial treatment and even developed symptoms
of its side effects which prompted the clinicians to change their medical approach in this case.
The paper then proceeded with discussing various laboratory results which may be of help in
deciphering the etiology and/or factors that could have precipitated such events to cascade such
as having an elevated potassium value in the urine. The measurement of blood pressure (BP),
blood gases, aldosterone, and renin will are helpful in arriving at a diagnosis. The blood pressure
in relation to my patient is elevated, blood gases are somewhat off, and the cortisol levels were
retested but a mineralcorticosteroid problem is a perspective my patients doctor were looking at
contrary to this articles patient where it was leaning towards a syndrome called Bartter
syndrome (BS) or Gitelman syndrome (GS) because of the hypomagnesemia occurrence.
Furthermore, I learned that Gitelham was what they were mostly expecting with the genetic
testing awaiting results. It was a genetic autosomal disorder causing salt losing disorder to
occur which prompted key clinical signs and symptoms leading to an initial diagnosis of
Hypokalemia.

Pauline Chan

Journal Review

N4A

Med Ward

Journal # 2: Toxicity of Weight Loss Agents by May Yen & Michele Burns Ewald
Review:
With the rise of cases of obesity, weight loss agents have become rampant with the medical
concerns that goes with it blind-sided in most humans approach at a fast and easy exit out of the
obesity lane along with its corresponding disease-related complications. With the rise of social
media and availability of drugs that claim to be the safest and easiest path to weight loss albeit its
status as an actual FDA approved drug, makes this situation an even harder one to address
especially for health care providers who are left dealing with the side effects and possible
toxicity of these drugs; these are without any studies that could fully support what and what they
dont do to the body. With a global estimation of a close to a billion people who are obese, it
does not come to a surprise that weight loss agents are popular over the past few years with a
new one emerging every few months or so. With the control of these drugs seemingly
impossible, this article attempted to review a handful of drugs that could potentially put its users
in danger with the adverse effects it poses. An example is Ipecac with a widespread report on
aspiration. Amongst its other severe adverse effects include Mallory-Weiss tears,
pneumomediastinum, and intracerebral hemorrhage.
The use of HCG, which is a hormone, along with low calorie diet, is also a type of weight loss
agent which claims to take 500 calories each day. It reports acute adverse effects include mild
hypotension, hypoglycemia, constipation, and fatigue and it also poses danger for thrombosis for
the client.

In conclusion, despite the governments attempt at prohibiting the usage of drugs that reportedly
allow patients to lose weight, there is no denying that the age of technology has taken over and
proper knowledge of adverse effects could help in educating clients in going against these
measures and instead proper education of weight loss through proper dieting and exercise should
be implemented.

Pauline Chan

Journal Review

N4A

Med Ward

Journal # 3: Etiology and symptoms of severe hypokalemia in emergency department

patients by Grischa Marti, Christoph Schwarz Alexander B. Leichtle, Georg-Martin
Fiedler, Spyridon Arampatzis, Aristomenis K. Exadaktylos and Gregor Lindner
Review:
This article aims to analyze the prevalence, etiology, and symptoms of severe hypokalemia in
patients presenting in the emergency department with the idea that electrolyte disorders are
already common in the emergency field. However, during this study, all patients entered in the
E.R. were all subjected to serum potassium labs which calculated in order to get the prevalence
of both hyper and hypokalemia. However, it is important to note that all that presented with
severe hypokalemia not attributed to any disorder are the ones considered as electrolyte
disorders. In conclusion of this initial study, most patients presented with hypokalemia or severe
hypokalemia which are potentially fatal to anybody should the levels drop down any lower than
2.0. In the patients recorded with severe hypokalemia, the mean median was 2.4 mmol, a value
already lower than the potentially dangerous levels of hypokalemia.
This implies that electrolyte disorders not to be overlooked and should be part of annual
researches as they could potentially cause death regardless of it being a primary electrolyte
disorder or a symptom of another disorder.