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Cynthia, a 53-year-old female presented to the emergency room due to feeling constantly tired, hungry, thirsty, and with frequent urination. Her past medical history is significant for cirrhosis and end-stage kidney disease. Physical examination had revealed yellowish discoloration to the skin, multiple bruises, bilateral edema, and weakness lasting more than three weeks. Laboratory tests were ordered (results provided below) after which she was prescribed metformin and informed to contact a doctor if she starts experiencing nausea, vomiting, fast breathing, and/or lethargy, as metformin has been known to cause metabolic acidosis.
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