A 50-year-old woman on ICU develops hospital-acquired hyponatraemia (Na+ 122 mmol/L, down from 138 over 36 hours). She is confused but not seizing. Sh...

Question

A 50-year-old woman on ICU develops hospital-acquired hyponatraemia (Na+ 122 mmol/L, down from 138 over 36 hours). She is confused but not seizing. She has been receiving IV 5% dextrose at 125 mL/hr for maintenance fluids. Urine osmolality is 100 mOsm/kg. What is the most likely cause?

Accepted Answer

Excessive hypotonic fluid administration causing dilutional hyponatraemia - the urine is maximally dilute indicating appropriate ADH suppression

Answer

SIADH

Answer

Cerebral salt wasting

Answer

Adrenal insufficiency

Answer

Hypothyroidism

uk-fficm MCQ (SBA): Iatrogenic Hyponatraemia

A 50-year-old woman on ICU develops hospital-acquired hyponatraemia (Na+ 122 mmol/L, down from 138 over 36 hours). She is confused but not seizing. She has been receiving IV 5% dextrose at 125 mL/hr for maintenance fluids. Urine osmolality is 100 mOsm/kg. What is the most likely cause?