Clinical Case Database / Category: Patient Management

An approach to a patient with symptomatic hyponatraemia

Publication details

Dr Emily Grist BM, Bsc (hons), Dr Mayank Patel BM, PhD, MRCP
Foundation Years Journal, volume 4, issue 5, p.5 (123Doc Education, London, May 2010)


You are the Foundation Year doctor called to see Mrs A, a 69-year-old patient admitted with worsening confusion over the last week. You are unable to obtain a detailed history from the patient. The GPs letter explains that the patient has been treated for a presumed chest infection with oral antibiotics 2 weeks prior. She was advised by the GP to “drink plenty of water” to keep hydrated. Her AMT is 2/10. She is afebrile with a respiratory rate of 24, oxygen saturations of 93% on air. You begin to examine Mrs A when she suddenly develops a tonic-clonic seizure.

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Dr Emily Grist BM, Bsc (hons)

Foundation Year 1
Southampton University Hospitals NHS Trust

Dr Mayank Patel BM, PhD, MRCP

Consultant in Acute Medicine and Diabetes
Southampton University Hospitals NHS Trust


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.