A 60-year-old man with chronic hyponatraemia (Na 120 mmol/L) due to syndrome of inappropriate antidiuretic hormone secretion (SIADH) from small-cell l...

Question

A 60-year-old man with chronic hyponatraemia (Na 120 mmol/L) due to syndrome of inappropriate antidiuretic hormone secretion (SIADH) from small-cell lung cancer is otherwise asymptomatic. What is the most appropriate initial management?

Accepted Answer

Fluid restriction and treatment of the underlying cause

Answer

Rapid correction with hypertonic saline aiming for Na 140 mmol/L in 24 hours

Answer

No treatment because he is asymptomatic

Answer

High-dose loop diuretics alone

Answer

Give desmopressin to further concentrate urine

ca-mccqe1 MCQ (SBA): Chronic hyponatraemia due to SIADH

A 60-year-old man with chronic hyponatraemia (Na 120 mmol/L) due to syndrome of inappropriate antidiuretic hormone secretion (SIADH) from small-cell lung cancer is otherwise asymptomatic. What is the most appropriate initial management?