A 52-year-old m an com plained to his physician of diarrhea, palpitations, and blurred vision. Five.

A 52-year-old m an com plained to his
physician of diarrhea, palpitations, and blurred vision. Five days earlier, the
m an was diagnosed w ith stage C systolic heart failure and started a treatm
ent w ith captopril, atenolol, and a standard dose of digoxin. Past history was
signi cant for hereditary nephrogenic diabetes insipidus, presently controlled
by hydrochlorothiazide (100 m g daily). W hich of the follow ing conditions
could have facilitated the appearance of the patients sym ptom s?

A. Advanced
age

B. Thiazide
treatm

A 52-year-old m an com plained to his
physician of diarrhea, palpitations, and blurred vision. Five days earlier, the
m an was diagnosed w ith stage C systolic heart failure and started a treatm
ent w ith captopril, atenolol, and a standard dose of digoxin. Past history was
signi cant for hereditary nephrogenic diabetes insipidus, presently controlled
by hydrochlorothiazide (100 m g daily). W hich of the follow ing conditions
could have facilitated the appearance of the patients sym ptom s?

A. Advanced
age

B. Thiazide
treatm ent

C. Hypernatrem
ia due to water depletion

D. Decreased
clearance of digoxin

E. Worsening
of the heart failure

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