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26. A 58-year-old male with a history of smoking presents with weight loss, cough, and mental confusion. A centrally mass is noted on a chest x-ray. Laboratory studies reveal the following:
a. Serum sodium 115 mEq/L
b. Serum chloride 81 mEq/L
c. Serum potassium 3.0 mEq/l
d. Serum bicarbonate 20 mEq/L
e. Random urine sodium 100 mEq/L ( < 20 mEq/L)
27. What is your diagnosis?
a. Diabetes insipidus
b. Nephrogenic diabetes
c. SIADH
d. Psychogenic polydipsia
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options are not appropriate..
because this mass could lead to an ectopic hormone production..
only one option has this possibility.. c
rest dont even match this q??
what is your opinion KASHMALA??
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this Q similar to one of the NBME q i did long time ago.ans shud be C as u can c all lab values have come down cuz of excess ADH..wat i din get is Na excretion of 100meq/L
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26. c- dilutional hyponatremia
27. c.
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SIADH is reght ...
and Na is high because ADH promote absorption of WATER AND UREA .... NO ELECTROLYTES ARE ABSORBED SO CONCENTRATION OF Na in urine increases.....
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Collegues I am trying to post ypou good questions ,NOT to compete..remember that...
I have a busy life as it is running a busniss, being a mom and in top of that trying to do this online.
I am NOT in ahurry to take step 1 beacsue I have pther priorities in the moment..but I am trying to help you and keep my self up to date..
so let focus on this CONCEPTS, not about this and that OK ?
The answer is innapropriete beacsue FIRST H/o of SMOKING, wt LOSS, cough suggest og Lung Ca and WHEN you see the NA -hypoinatremia then you think ..aha ...paraneoplastic syndrom such this on ecan secrete ectopic hormons lik ein this case ADH , we are saying ectopic beacsue this ADH primary is not secreted from the tumor rigth, and then increase ADH by definition is =SIADH and VOILA...............
Voard question big time for STEP 1 and STEP 2
