A 61-year-old patient presents with dizziness and confusion and has had an upper respiratory tract infection (URTI) for 3 days. The patient is in a hyperosmolar state. Laboratory results: Na⁺: 117 mmol/L K⁺: 3.2 mmol/L Cl⁻: low Ca²⁺: normal Urine osmolality: 900 mOsm/kg Which is the most likely diagnosis?
سؤال مجاني 4 من 10 اليوم · اشترك وكمّل بدون حد
اعرض الإجابة
الإجابة والشرح
ادخل لحسابك عشان نحفظ إجاباتك ونوريك أخطاءك.
المصادر مختلفة. ملفات الدفعة فيها إجابتين، وما نرجّح وحدة على الثانية. سبب كل وحدة في الشرح تحت:
- إجابة: B. Uncontrolled Diabetes Mellitus
- إجابة ثانية: A. SIADH
Hyponatraemia with a raised serum osmolality (hypertonic hyponatraemia) is caused by an osmotically active solute such as glucose, which pulls water out of cells. An older patient made confused by an infection while hyperosmolar therefore fits uncontrolled diabetes / hyperglycaemia (B).
- SIADH (A) needs hypo-osmolar serum (<275) with concentrated urine (>100) and euvolaemia. Infections are a known cause, and urine osmolality 900 would fit it if the serum were hypo-osmolar.
- Diabetes insipidus (C) causes hypernatraemia with dilute urine. Water intoxication (D) gives dilute urine.
- المصدر
- RENAL-02 Sodium Disorders [Notes 2.11].pdf · p. 10
Nephrology 🌷.pdf · p. 36 - المحاضرة
- Electrolytes (Na & K) · Nephrology · Module C
- ظهر في
- MED43 ♀ Quiz C