A 45-year-old man presented with severe dehydration. He has been diagnosed with mental depression. He is prescribed with anti-psychotic medications including lithium. He is also a heavy smoker.   Analyte (serum)ResultReference intervalSodium185135 – 145 mmol/LPotassium3.93.5 – 5.5 mmol/LChloride12795 – 110 mmol/LGlucose5.83.5 – 5.6 mmol/LSerum osmolality408275 – 295 mOsmo/kgUrine osmolality187Not availableHis urine osmolality is lower than serum osmolality. What may have caused this observation? Group of answer choicesWatery urineExcess glucose excreted in urineExcess sodium excreted in urineExcess chloride excreted in urine

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

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 36-year-old man presents with the following blood biochemistry 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/1.73m2Considering the abnormal results, what is the likely diagnosis for this patient?Group of answer choicesHe has acute kidney diseaseHe is on thiazide diureticsHe has metabolic acidosisHe has chronic diarrhea

E.l is a 35-year-old 65kg white male being treated for acute mania .he is receiving 300mg lithium carbonate 3 time daily. His serum creatinine concentration is 0.9mg/dl. Calculate the expected lithium concentration just before the morning dose on the forth day of therapy.

A 30-year-old man was administered in the Accident and Emergency (A&E) department of a metropolitan hospital. He appeared partially conscious and extremely weak. His biochemical blood results are:Analyte (SERUM)ResultReference intervalSodium121135 – 145 mmol/LPotassium5.63.5 – 5.5 mmol/LChloride8695 – 110 mmol/LBicarbonate1922 – 32 mmol/LUrea10.93.0 – 8.0 mmol/LCreatinine9840 – 90 μmol/LSerum osmolality340275 – 295 mOsm/kgWhat could have explained his altered serum electrolytes and osmolality?Group of answer choicesHe has acute kidney injury (AKI)Uncontrolled hyperglycaemiaHe has Conn’s syndromeHe has chronic kidney injury (CKD)