Welcome, my name is Devine. This is episode 48 of the Devine Intervention

Podcasts. Into this podcast will be continuing the step-to-step-through

rapid review series. This will be Series 105. Let's begin.

What if they give you a question about a 71 year old male and you're told that for the

last three weeks he has had recurrent seizures or let's make

him more realistic let's say for the last one week he has had recurrent seizures and you're also told that he has lost quite a bit of weight over this time period and you're told that he has skin hyperpigmentation.

What should you be thinking about?

And then let's say they give you a sodium

and the sodium is like 124 or something really low like that. What should you be thinking about?

Well I would really hope you're saying that, oh, Devine, sounds like this guy has small cell on cancer.

Again, remember the USMILies are just about putting things together.

He'd be like, come on, Devine, like,

how did you get to small cell lung cancer?

Well, how did I get there?

Well, let's explain number one. This guy has been having seizures and okay you see seizures.

What may be the cause? Okay, well, it has low sodium.

So you have 124 is not great, right? It's just pretty bad. So this person has hyponitremia.

You see skin hyper pigmentation,

put it all together, it's an older person. That skin hyper pigmentation should make you think of

maybe this person has a lot of ECTH running around because ECTH is not

made in a vacuum, right? It's made from Palm C together with MSA. So whenever your ECTH is high, you can have high levels of

MSAH, that's the monitor sites. I can guess skin hyperpigmentation.

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