doc179
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A 55-year-old woman has had a 4 kg weight loss over the past 3 months. She exhibits decreased mentation over the past 10 days. On physical examination she is afebrile and hypotensive. Bilateral papilledema is noted. A head CT scan shows marked diffuse cerebral edema with effacement of the lateral ventricles. Laboratory studies show a sodium of 108 mmol/L, potassium 4.0 mmol/L, chloride 83 mmol/L, CO2 14 mmol/L, glucose 82 mg/dL, and creatinine 0.5 mg/dL. Which of the following is most likely to cause these findings?
A Small cell lung carcinoma
B Blunt head trauma
C Hypothalamic glioma
D Meningitis
E Pituitary macroadenoma
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| po
Forum Elite
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B
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| virgola82
Forum Guru
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A -> SIADH. Why you think B?
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| Luckyall
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this is a classic SIADH but it can be due to head injury or Oat cell carcinoma... so is either A or B  Im thinking IF the Qs writer would want us to answer " small cell Carcinoma" ..they d' ve said something like smoker or an abnormal lung feature ...
therefore my answer is B) blunt head trauma
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| virgola82
Forum Guru
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weight loss ifor 3 months sounds to me like cancer....
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| Luckyall
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you right..tricky crazy Qs is A
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| new_n_lost
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A Small cell lung carcinoma << MCC of SIADH Classical Signs Hyponatremia < 120 mEq/L & cerebral edema Signs with Altered Mental Status.
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| Medusin
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good question...
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| po
Forum Elite
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2nd thought B epidural hematoma common after 60/70yrs so I feel I was wrong,what is final answer doc179?
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| doc179
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sorry guys was nt at home, could not get online , sorry to have kept you waiting.
(A) CORRECT. This is the most frequent cause for the syndrome of inappropriate ADH (SIADH). Paraneoplastic syndromes are often seen with oat cell carcinomas.
(B) Incorrect. Such trauma could damage the hypothalamic-pituitary axis enough to lead to diabetes insipidus, but not excessive ADH secretion.
(C) Incorrect. Lesions of the hypothalamus are uncommon, and destruction of this region by a glioma would result in loss of ADH with diabetes insipidus.
(D) Incorrect. Meningitis might produce enough inflammation to interfere with ADH secretion and cause diabetes insipidus, not excess secretion of ADH.
(E) Incorrect. Such a neoplasm could theoretically result in diabetes insipidus from a LACK of antidiuretic hormone.
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