A 54-year-old woman undergoes pituitary surgery for a non-functioning macroadenoma. On postoperative day 1, she develops polyuria (800 mL/hour) and severe thirst. Vital signs show HR 102/min, BP 138/88 mmHg, RR 16/min. Laboratory studies reveal serum sodium 165 mEq/L, osmolality 320 mOsm/kg, and urine osmolality 100 mOsm/kg. Urine specific gravity is 1.002. She denies recent diarrhea. Which pathophysiologic mechanism best explains these findings?
- A)Syndrome of inappropriate antidiuretic hormone secretion
- B)Hypovolemic shock from surgical bleeding
- C)Primary polydipsia from anesthesia effects
- D)Transient central diabetes insipidus from ADH depletionGABARITO
- E)Hyperaldosteronism from surgical stress
Explicação
Transient central diabetes insipidus commonly occurs 24-72 hours after pituitary surgery due to disruption of ADH release from the posterior pituitary and neurohypophyseal stalk. The massive polyuria with dilute urine and elevated serum osmolality is character... Ver explicação completa e trilha adaptativa →