sfk
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A 68-year-old woman presents with an obviously incarcerated umbilical hernia. She has gross abdominal distention, is clinically dehydrated, and reports persistent fecaloid vomiting for the past 3 days. Although tired, weak, and thirsty, she is awake and alert and her sensorium is not particularly affected. Laboratory analysis reveals a serum sodium concentration of 118 mEq/L. Which of the following is the most likely physiologic explanation for the serum sodium?
A. She has acute water intoxication
B. She has been vomiting and trapping hypertonic fluids in the bowel lumen
C. She has vomited and sequestered sodium-containing fluids, and has retained endogenous and ingested water
D. There must be a laboratory error, because such a serum sodium level would have produced coma
E. Volume deprivation leads to renal wasting of sodium
Edited by sfk on 04/18/08 - 04:56 PM
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| ansalshah
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CCCCCCCCccc
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| liliaeliz
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A or C?
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| GOGETA
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So what is the answer?
For Hypo Na+ with low volume
it seems she is dehydrated so when you vomit and when you have diarrhea you loose more Na+ than water.
Also D is incorrect because if the lose of NA+ is gradual and slow the brain and adapt, so you will not have the sig and symtons in an acute hypo state.
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| smalley
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C she is losing na etc through thru vomitting and trapping all the available water
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| sfk
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yes, answer is C. smalley gave correct explanation.
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