nephro q1 - newbiemd

[ArchivalUser]

thanks newbiemd, il go for D.

[ArchivalUser]

answer d please read below

This patient has inappropriate renal water conservation. Which form of inappropriate antidiuretic hormone stimulation is present is not yet diagnosed.

All forms of hyponatremia are caused by retention of water in excess of sodium; therefore, sodium loss itself is never the primary explanation for hyponatremia. Although diuretic administration can be associated with hyponatremia, the mechanism is thought to be due to diuretic-induced sodium and water loss, producing extracellular volume depletion causing antidiuretic hormone stimulation and resulting in renal water conservation in a patient taking hypotonic fluids. Diuretic administration is usually associated with an increased or normal uric acid level, and water conservation with a decreased level.

Pseudohyponatremia is a method-dependent, artifactual reduction of serum sodium concentration resulting from displacement of a portion of the water phase of the plasma by lipid (for example, in severe hypertriglyceridemia) or by protein (for example, in multiple myeloma). This problem occurs only when electrolytes are measured by flame emission spectrometry and can be avoided by using a sodium-selective electrode measurement method. The former method is being used in fewer laboratories; the latter is increasingly the norm.

Hyponatremia caused by ingesting very large volumes of water is quite rare, requiring a dramatic increase in water consumption that exceeds the kidneys™ ability to excrete water. If this were the case, the urine concentration would be very low (specific gravity of less than 1.005) which is not true in this patient.

Dietary sodium intake can range from very high to almost zero without there being any significant effect on plasma sodium concentration. The sodium concentration is most related to the water content of the body, not sodium content.

[ArchivalUser]

vammfire.. what made you think it was D...

[ArchivalUser]

but if D then shouldn't the specific gravity be inappropriately high?