Abnormal Sodiumppt - medStation：异常sodiumppt - medstation.ppt

* * * * * * * * * * * * * Questions: 3) A 3 year old is admitted with gastroenteritis and dehydration. His serum sodium is 167 mEq/L. Once he is hemodynamically stable, fluid management should be focused on providing: A) Glucose B) Free water C) Sodium D) Potassium E) Chloride Questions: B is the correct answer. Hypernatremia is a total body free water deficit rather than an excess of sodium. Questions: 4) All of the following are possible etiologies for hyponatremia EXCEPT: A) Dilute formula feeding B) SIADH C) Diabetes insipidus D) Non-osmotic release of ADH secondary to acute illness Questions: C is the correct answer. Diabetes insipidus leads to hypernatremia. Questions: 5) A 2 year old patient with central diabetes insipidus is admitted with a sodium of 170 mEq/L. The labs findings most consistent with his diagnosis are: A) Elevated serum osmolarity and concentrated urine B) Decreased serum osmolarity and dilute urine C) Decreased serum osmolarity and concentrated urine D) Elevated serum osmolarity and dilute urine Questions: D is the correct answer. Central diabetes insipidus leads to decreased ADH production. This leads to an inability to concentrate urine and an increase in serum osmolarity, hypernatremia and dilute urine. Questions: 6) A 4 month old has been receiving improperly mixed formula with 1 scoop per 4 oz of water. She presents with generalized tonic-clonic seizure and a serum sodium of 118 mEq/L. The appropriate fluid to use for immediate management of her hyponatremia is: A) Normal saline B) 1/2 Normal saline C) 3% Hypertonic saline D) None-fluid restrict due to concern for SIADH Questions: C is the correct answer. This is a straightforward knowledge question requiring learners to recall that symptomatic hyponatremia is an emergency requiring prompt treatment with hypertonic saline. Discussion: The facilitator should stop at the end of the slide and have the learners think about these questions out loud. Faciliatator can refer to han