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NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 4/Question#45 (reveal difficulty score)
A 72-year-old woman has hyponatremia 3 days ...
Inappropriate ADH (vasopressin) secretion ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
tags: renal inc

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submitted by โˆ—step_prep5(246)
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  • Elderly patient with cerebral disease who has hypo-osmolar hyponatremic with increased urine sodium (>40) and urine osmolarity >100, consistent with SIADH
  • Key idea: Causes of SIADH include ectopic ADH (small cell lung cancer), pulmonary disease, CNS disorders or head trauma (such as infarction), and drugs (cyclophosphamide)
  • Dehydration โ€“> Low urine sodium (<40) because the body is trying to retain as much sodium and water as possible
  • Water intoxication โ€“> Low urine osmolality (often <100) because so much water is being consumed and excreted that the urine is very dilute

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