Name: Rhonda Sturley       

Theme: Sodium Handling

 

OPTION LIST

 

A	ACE Inhibitors	I	Pseudo-hyponatraemia
B	Addison’s Disease	J	Psychogenic Polydipsia
C	Chronic Renal Failure	K	SIADH
D	Conn’s Syndrome	L	3 mmol/Kg
E	Diabetes Insipidus	M	13 mmol/Kg
F	Diabetes Mellitus	N	297 mmol/Kg
G	Diuretics	O	390 mmol/Kg
H	Nephrotic Syndrome	P	504 mmol/Kg

 

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 24 year old, otherwise healthy type 1 diabetic was admitted to A&E after suffering from loss of consciousness following a hypoglycaemic episode. Blood results taken by the medical student attached to the on call team showed a hyponatraemia.

 

 

2. A 65 year old female with Na⁺ - 122 mmol/L, plasma osmolality – 255 mmol/Kg, urinary sodium – 23 mmol/L, urine osmolality – 506 mosml/Kg and normal renal, adrenal and thyroid function. The patient has been on tricyclic antidepressants.

 

 

3. A 16 year old complaining of polyuria and polydipsia (4-5 l/day) has a mild hyponatraemia and low urine osmolality. She later tells you that she has been having problems at home. A water deprivation test showed a urine osmolality of 500 mosmol/Kg.

 

 

4. A 28 year old male presents with weakness, weight loss and abdominal pain. Investigations show hyperkalaemia, hyponatraemia, hypoglycaemia and mild acidosis. A chest x-ray shows calcification, consistent with previous TB.

 

 

5. Na⁺ - 140 mmol/L, K⁺ - 4 mmol/L, Urea – 4 mmol/L, Glucose – 5 mmol/L, Measured Plasma Osmolality – 300 mmol/kg. Choose the correct osmolar gap from the above choices.

 

 

 

ANSWERS

1. I

2. K

3. J

4. B

5. L