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+--- Thread: Why not hypertonic saline??????? - vatsalshruti (/showthread.php?tid=637530)
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Why not hypertonic saline??????? - vatsalshruti - ArchivalUser - 12-04-2011
1. A previously healthy 52-year-old man comes to the emergency department because of hiccups for 1 week. He has smoked two packs of cigarettes daily for 30 years. He does not drink alcohol. He is alert and oriented. His temperature is 37 C (98.6 F), blood pressure is 150/95 mm Hg, pulse is 70/min, and respirations are 12/min. Physical and neurologic examinations show no abnormalities. His serum sodium level is 120 mEq/L. An x-ray film of the chest shows a right hilar mass. Which of the following is the most appropriate next step in treatment?
A
) Bisphosphonate therapy
B
) Calcitonin therapy
C
) Calcium therapy
D
) Dexamethasone therapy
E
) 5% Dextrose in 0.225% saline therapy
F
) 5% Dextrose in 0.45% saline therapy
G
) 5% Dextrose in water therapy
H
) Fluid restriction
I
) Hydrocortisone therapy
J
) Lactated Ringer's solution
K
) Mannitol therapy
L
) Potassium therapy
M
) 0.9% Saline therapy
N
) 3% Saline therapy
O
) Sodium bicarbonate therapy
0 - ArchivalUser - 12-04-2011
Hypertonic saline is for very severe hypona+
ver severe means lethargy , seizure and coma
Mtb 2 pg 332
0 - ArchivalUser - 12-04-2011
M) The Patient is stable shows that the process of SIADH secretion has been chronic and it should be treated slowly.Agressive treatment with hypertonic saline causes central pontine myelinelysis syn!
0 - ArchivalUser - 12-04-2011
@ residencytrial, uburger ,
Thanks a lot 4 exp...
I've posted some other doubts. Plz guys give ur inputs...
0 - ArchivalUser - 12-04-2011
WHY NOT....H...
0 - ArchivalUser - 12-04-2011
@raheem, thanks for joining us..
I just read the previous discussion of amirh on this & he explained for H- fluid restriction
I've read in UW- SIADH mild-fluid restriction
moderate- NS
severe- hypertonic saline
As the pt is stable, i think we shd start from fluid restriction..
Guys any inputs r welcome
4 - ArchivalUser - 12-04-2011
h.
0 - ArchivalUser - 12-04-2011
AGREE!! H is correct!
0 - ArchivalUser - 12-06-2011
H ;makes sense to start with fluid restriction in Mild SIADH; In moderate SIADH NS; &in severe Hypertonic sol.
0 - ArchivalUser - 12-06-2011
yup it shud b H