65-year-old widow, had long-standing HTN that was unsatisfactorily controlled on a variety of agents. Her drug therapy included :Furosemide 40 mg once a day, Amlodipine 10 mg daily & Salt restricted diet.
Following a routine review of her therapy®Ramipril 2.5 mg once daily was added to her treatment regimen in an attempt to improve BP control. She was recently diagnosed with gastroenteritis. A week after her diagnosis she presented to her local hospital accident & emergency unit, with ongoing diarrhea. Her BP was found to be 100/60 mmHg &serum biochemistry revealed
Cr levels of 225 μmol/L (50–120 μmol/L)
Na+ 125 mmol/L (135–145 mmol/l)
K+ 5.2 mmol/L(3.5–5.0 mmol/L).
Q1. What was the likely cause & underlying mechanism to this
patients's problem?
Q2. What treatment should be given?