MRCP2-1067

MRCP2-1067

A 35-year-old man presents to the Emergency Department two weeks after being discharged following surgery for a ruptured appendix. He experienced significant blood loss during the procedure and required a blood transfusion. He has been feeling increasingly fatigued with episodes of dizziness and near-fainting. On examination, he appears pale and his blood pressure is 100/70 mmHg with a 15 mmHg drop on standing. His pulse is 90 bpm and regular. His BMI is 25 kg/m2.

Investigations:
Haemoglobin (Hb): 105 g/l (normal range: 130-170 g/l)
White cell count (WCC): 7.5 × 109/l (normal range: 4-11 × 109/l)
Platelets (PLT): 180 × 109/l (normal range: 150-400 × 109/l)
Sodium (Na+): 132 mmol/l (normal range: 135-145 mmol/l)
Potassium (K+): 5.2 mmol/l (normal range: 3.5-5.0 mmol/l)
Creatinine (Cr): 100 µmol/l (normal range: 50-120 µmol/l)

What is the underlying pathology causing this patient’s symptoms?