Abanga was rushed to the hospital on account of fainting, shortness of breath, palpitations and nausea. On assessment, Abanga was pulseless, with the unrecordable blood pressure but a heart rate of 450bpm. His ECG showed no P-wave nor QRS complex. His Hb was 7.0g/dL (normal range 12.5-16.5g/dL) and MCV was 70fL (normal 80-100fL). Abanga’s drug history indicated that he has been taking an antacid (aluminium hydroxide mixture) for the past three months now due to his palpitations and was on prescribed ferrous sulphate which he has been taking for the past one month due to a previous diagnosis of anaemia. An impression of arrhythmia and anaemia was made by the physician and Abanga was defibrillated with electrical shocks and started on verapamil, warfarin and adrenaline. Laboratory investigations the next day showed high serum potassium levels.

1. What type of arrhythmia and anaemia is Abanga likely to be suffering from?

2. Assign reasons to your answers in question 1 above.

3. From Abanga’s clinical case presented, could you guess the cause of his anaemia?

4. Do you agree with the choices of verapamil, wafarin and adrenaline for Abanga’s condition? Assign reasons.

5. With reasons, what will you suggest to the doctor to improve drug treatment arrhythmia for Abanga?