ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
Q-If a patient having nephrogenic diabetes insipidus is given osmotic diuretic agent, what will be the effect on urine osmolality?
a) increase
b) decrease
c) no change
Give your reasoning!
___________________
life is guud
|
| usmlee
Forum Senior
Topics: 3
Posts: 21
|
I think osmotic diuretic will not make any change..because urine is already hypo osmotic..
|
| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
no...try again :evil:
___________________
life is guud
|
| Addicudo
Forum Guru
Topics: 124
Posts: 615
|
huMmm ..
Decrease in urine osmolarity!
Urine is hypoosmolar ... because of ADH insufficiency -
Then you gave Osmotic diuretic ... further retention of water ..
Will also lead to Hypernatermia, Dehydration shock, Pulmonary edema !
Am i correct ?
___________________
... Idle hands are the DeVilS play ground ...
|
| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
sorry dude.....
try again!
:shock:
HINT: consider free water clearance and related variables
___________________
life is guud
|
| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
answer is a)increase
in DI because of +ve free water clearance .... any osmotic agent will accomodate .....however it's osmotic effect will not be seen untill it's osmolality in the urine rises significantly.
As the load of excreted solute is increased ,the concentration in urine will increase untill it reaches tht of plasma.....because with increasing osmolality ,an increasing large fraction of the excreted urine will be proximal tubular fluid.
___________________
life is guud
|
| guayoman
Forum Elite
Topics: 44
Posts: 273
|
What does it mean to accomodate for an osmotic diuretic? Also :oops: why is it indicated to administer Osm diuretics in DI?
___________________
Confidence does not come from simply reading the content, but from doing things with it. Confidence is born in the flash of insight, in the ability to face something new and figure it out.
Kaplan usmle edge newsletter
|
| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
it was q in ganong old edition......ofcourse u won' administer osmotic agent in pt with DI.!
forget DI.....the main point is tht osmotic agent will hold back water in the tubules which can alos occur in DM tht's the resaon osmolarity of the urine in DM is same as tht of plasma as glucose is the major determinant of both urine a/a plasma in pt with DM!
___________________
life is guud
|
| guayoman
Forum Elite
Topics: 44
Posts: 273
|
and it turns out in Washington MAnueal for Int Med that they use Thiazide diuretics!!!! :shock: What the ....!!!?? Seems like I have to go read some more! :lol:
___________________
Confidence does not come from simply reading the content, but from doing things with it. Confidence is born in the flash of insight, in the ability to face something new and figure it out.
Kaplan usmle edge newsletter
|
| ssrpk
Forum Fanatic
Topics: 154
Posts: 2,819
|
hey tht's a different story!
ever heard abt paradoxical inc in proximal tubular reabsorption....tht's the effect of thiazides!
___________________
life is guud
|
|
| |
| | | | | | | | | | |
