Perhaps
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A 6-year-old boy with cystic fibrosis is brought to the physician by his mother because his skin has been cool and clammy for 30 minutes. Earlier in the day, he had been playing outdoors, and the temperature was 99 F. When returning indoors, he was thirsty and restless. His blood pressure is 70/40 mm Hg, and pulse is 120/min. Examination shows dry mucous membranes. Serum sodium level is 128 mEq/L, and serum chloride level is 87 mEq/L. Which of the following is the most likely explanation for these findings?
A) Excessive sweat electrolyte level
B) Excessive sweat volume
C) Excessive urinary output
D) Excessive vasopressor secretion
E) Inadequate sweat production
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| djacosta
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i think a
not sure i know cf causes a hyponatremic dehydration...
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| juanma0
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I go with A.
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| Perhaps
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thanks
i went with A too.
but on the other hand, solute in the sweat might drag fluids out.
not sure
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| humbty
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I took B because the boy is dehydrated if it would be only excessive electrolyte loss he wouldnt be dehydrated.
I mean the low sodium would be explained by A but I wasnt sure what was meant with finding, the low sodium or his dehydration.
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| rezaaa
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hey guys if he was dehydrated wouldnt his sodium and chloride be increased rather than decreased due to hemoconcentration. i picked A cuz in CF there is excess sodium and chloride loss in sweat in hot conditions
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| peter90036
Forum Elite
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someone can comprehend the following better?
as i understand there is excessive sweating  + excessive sweat sodium
"Patients with cystic fibrosis are adversely affected by high temperatures. Excessive sweating leads to massive sodium loss with vascular collapse; coma may result, especially when combined with an intake of unsalted water. Laboratory investigations show hyponatraemia, hypokalaemic alkalosis, and dehydration."
http://www.bmj.com/cgi/content/full/310/6979/579
i thought water follows sodium not the other way around...?
Edited by peter90036 on 03/24/08 - 03:47 PM
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