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SIADH

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bobby
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Topics: 136
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04/05/04 - 11:52 AM

following are characteristics of inappropriate ADH secretion except
A. edema and hyperuricemia
B. excessive ADH secretion
C. normal burn and creatine
D. increased serum osmolality
E. hypotension and hypothermia

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usmleasr
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04/05/04 - 12:01 PM

D.inc serum osmolality

asmi
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04/05/04 - 03:44 PM

yep D

bobby
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04/05/04 - 09:41 PM

yea, D was my ans also, but to my greatest surprise, the ans given was A. just can't understand how the reasoned it out :!:

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Idiopathic
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04/05/04 - 09:51 PM

Thats right. If edema is present, then by definition, you cannot have siADH. You MUST have increased total body Na+ to have edema.

siADH can be diagnosed if:
have less than dilute urine osmolality (>50 mOSM or >1.010 SG)
no edema
have no other renal or adrenal problems

asmi
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04/05/04 - 10:10 PM

Thats right bobby,

:arrow: there is normal TBNa+ there will be no edema on physical exam.(serum Na = TBNa+/TBW)

lab exam will show low serum BUN and uric acid.(which are lost in urine with Na+ from decreased proximal reabsorption)

Thus A is correct

You can refer goljan's path review for more info .

Idiopathic
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04/05/04 - 10:12 PM

"asmi" wrote:
You can refer goljan's path review for more info .

He claims to have come up with this concept by the way (no edema unless increased TBNa+)...you never know with him

asmi
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04/05/04 - 10:34 PM

"Idiopathic" wrote:

"asmi" wrote:
You can refer goljan's path review for more info .

He claims to have come up with this concept by the way (no edema unless increased TBNa+)...you never know with him

so, do you think its wrong ..?

Idiopathic
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04/05/04 - 10:50 PM

No, its definitely right...but did he really come up with it? Thats what I mean grin

asmi
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04/06/04 - 07:38 AM

#10

"Idiopathic" wrote:
No, its definitely right...but did he really come up with it? Thats what I mean grin

:roll: :roll:

Malaysian
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Topics: 28
Posts: 778

04/09/04 - 05:42 AM

#11

SIADH does not show oedema.....thats a fact...no need referring Goljan for that.SIADH will also have a fall in the osmolarity but hyperosmolar urine.I think it must be a misprint regarding the increased serum hyperosmolality...however if I'm made to choose I'll stick with A....emphasizing the point statement A makes!!

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