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A 48-year-old man felt drowsy. He was alone at home on a warm Australia Day long weekend. He collapsed in the backyard and was fortunately discovered by his son later. He was sent to the Emergency department. His blood biochemical results are:Analyte (SERUM)ResultReference intervalSodium158135 – 145 mmol/LPotassium5.53.5 – 5.5 mmol/LChloride11895 – 110 mmol/LBicarbonate2922 – 32 mmol/LFasting glucose3.83.6 – 5.5 mmol/L* Note: Urine osmolality is normalWhat is the likely reason explaining his high sodium result?Group of answer choicesExcessive loss of body fluidDiabetes insipidusOsmotic diuresis due to diabetes mellitusAddison’s disease

Question

A 48-year-old man felt drowsy. He was alone at home on a warm Australia Day long weekend. He collapsed in the backyard and was fortunately discovered by his son later. He was sent to the Emergency department. His blood biochemical results are:Analyte (SERUM)ResultReference intervalSodium158135 – 145 mmol/LPotassium5.53.5 – 5.5 mmol/LChloride11895 – 110 mmol/LBicarbonate2922 – 32 mmol/LFasting glucose3.83.6 – 5.5 mmol/L* Note: Urine osmolality is normalWhat is the likely reason explaining his high sodium result?Group of answer choicesExcessive loss of body fluidDiabetes insipidusOsmotic diuresis due to diabetes mellitusAddison’s disease

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Solution

The likely reason explaining the high sodium result in this 48-year-old man is the excessive loss of body fluid.

Here's why:

  1. Sodium is an electrolyte that plays a crucial role in maintaining the balance of water in and around your cells. It's essential for proper muscle and nerve function. It also helps maintain stable blood pressure levels.

  2. The normal range for sodium in the blood is 135 – 145 mmol/L. In this case, the man's sodium level is 158 mmol/L, which is higher than the normal range. This condition is known as hypernatremia.

  3. Hypernatremia often occurs when there's an imbalance in the level of water and electrolytes in your body. It's typically caused by the body losing too much water. This can happen for a variety of reasons, such as excessive sweating, not drinking enough water, or urinating too much.

  4. In this case, the man was found collapsed in the backyard on a warm day. It's possible that he was dehydrated due to excessive sweating and not drinking enough water, leading to an excessive loss of body fluid.

  5. The other conditions mentioned (Diabetes insipidus, Osmotic diuresis due to diabetes mellitus, Addison’s disease) can also cause hypernatremia. However, based on the given information, excessive loss of body fluid seems to be the most likely cause.

  6. It's important to note that this is a possible explanation based on the given information. The actual cause can only be determined by a healthcare professional after a thorough examination and additional tests.

This problem has been solved

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A male patient at 75 years old is worrying about his hypertension and consulted his family doctor. His blood biochemistry results show:Analyte (SERUM)Result Day 1Result Day 3Reference intervalSodium125120135 – 145 mmol/LPotassium2.52.83.5 – 5.5 mmol/LChloride869095 – 110 mmol/LBicarbonate353222 – 32 mmol/LUrea7.07.23.0 – 8.0 mmol/LCreatinine908640 – 90 μmol/L* Urine sodium = 58 (<20 mmol/L in low sodium)In general, which medication may cause a decrease in serum potassium?Group of answer choicesPotassium-sparing diureticBeta-adrenergic blockerBeta-adrenergic agonistDigoxin

A 63-year-old woman suffers from congestive heart failure. She went to see her cardiology for routine monitoring of her conditions. She presented the following results:Analyte (SERUM)ResultReference intervalSodium146135 – 145 mmol/LPotassium6.83.5 – 5.5 mmol/LChloride10895 – 110 mmol/LBicarbonate2222 – 32 mmol/LUrea36.63.0 – 8.0 mmol/LCreatinine37740 – 90 μmol/LeGFR50> 90 ml/min/1.73m2What has caused the raised potassium?Group of answer choicesInhibition of Na/K/ATPase pump by medicationTumour lysis syndromeOsmotic diuresisShe has metabolic alkalosis

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