Chronic Knee Pain in Medicine / Internal Medicine — Case | Nephrology | SMLE Q#11611

SMLE Question #11611

Medicine / Internal Medicine Nephrology

Objective: OBJ-188

Last updated: February 2026
A 72-year-old nursing home resident has 2 days of increasing confusion and lethargy after 3 days of poor oral intake and several episodes of non-bloody vomiting. He takes high-dose ibuprofen for chronic knee pain. Examination shows dry mucous membranes, decreased skin turgor, and no peripheral oedema. Staff report limited access to free water over the past 3 days. Which of the following is the most likely electrolyte abnormality?

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