Year Woman Presents Explained for Students (Easy Guide)

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Original Question

50-year-old woman presents to the hospital due to altered mental status. The patient lives alone and was found by neighbors to be acting erratically outside of her house. The patient is unable to appropriately answer questions in the emergency room. Her medical history is significant for schizoaffective disorder. Her medications include olanzapine and sertraline. She drinks one to two beers daily and smokes ½ pack-per-day of cigarettes. Vital signs are within normal limits. The patient has a normal heart, lung, and abdominal examination. Jugular venous pressure is at 8 cm H20 and there is no lower extremity edema. Her serum sodium is 118 mEq/L. Urine studies are displayed below. Which of the following is the most likely cause of hyponatremia in this patient? Urinalysis Patient Urine Electrolytes Patient Leukocytes Neg Urine Sodium (mEq/L) 10 Nitrite Neg Urine Osm (m0sm/kg) 80 Urobilinogen Neg Protein Neg pH 6.5 Blood Neg Specific Gravity 1.003 Ketone Neg Bilirubin Neg Glucose Neg (A) Cirrhosis (B) Diabetes insipidus (C) Primary polydipsia D) Renal sodium loss (E) Syndrome of inappropriate antidiuretic hormone secretion

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