Theme: Weakness
Keywords: Muscle Weakness; Hypokalaemia; Renal Tubular Acidosis; NSAIDs
A 38-year female presented with difficulty walking due bilateral leg pain and weakness over the preceding 24 hours. This was associated with shortness of breath and generalised lethargy.
Past Medical History:
Asthma
A Provoked Pulmonary Embolus one month previously, for which she was still taking Apixaban.
Recurrent chronic pain which is managed with prescribed and OTC analgesia, specifically Ibuprofen and Paracetamol regularly, but to poor effect
Her observations were as follow:
HR 115, BP 85/52
Sats 98% on 4L, RR 22
Temp 36.2
On examination:
Chest was clear to auscultation;
Heart sounds were normal;
Abdomen was soft, non-tender;
Cranial nerve examination was normal;
Neurological examination revealed proximal upper limb weakness (MSC 4/5), proximal lower limb weakness (MSC 3/5) with in-tact sensation and reflexes.
