Pre-Activity Questions

Evelyn is a 62-year-old woman who presented to the hospital emergency department with generalized weakness, nausea, headache, and anorexia. Examination was unremarkable; no edema was observed. Blood glucose and renal and liver function tests were within normal limits. Chest CT revealed a soft-tissue density mass involving the left para-aortic, para-tracheal, and right hilar regions. Laboratory results were as follows: K+ 3.5 mEq/L, Ca++ 8.1 mg/dL, uric acid 3.4 mg/dL, serum Na+ 127 mEq/L, urine osmolality 353 mOsm/kg H20, urine Na+ 138.8 mmol/L, and plasma osmolality 246.8 mOsm/kg. TSH and cortisol levels were within normal limits. 

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For the next 2 days, Evelyn's laboratory data are as follows:

Measurement

Day 1

Day 2

Serum sodium

128mEq/L

129mEq/L

24-hr urine output

755 mL

910 mL

Urine osmolality

633 mOsm/kg H20

601 mOsm/kg H20

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Please use the scale: 1=NOT at all confident, 2=Not very confident, 3=Somewhat confident, 4=Confident, 5=Very confident
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Treatment of chronic hyponatremia
Determining the correction rate for sodium levels in the hyponatremic patient
Selection of appropriate patients for use of vasopressin receptor antagonists
Describing the pathophysiology of hyponatremia in tumor-related conditions
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True or False
TrueFalse
A patient with brain metastases and cerebral salt wasting
A patient with SCLC, hyponatremia, and serious neurologic symptoms
A patient with SIADH, moderate symptoms, and serum sodium of 124 mEq/L