A 24 year old man develops severe polyuria and polydipsia 3 days after transsphenoidal surgery for a pituitary adenoma. Serum sodium is 152 mEq/L and urine osmolality is low. Administration of desmopressin markedly increases urine osmolality. Which of the following is the most likely cause of his water balance disorder?
- A)Inadequate secretion of ADHGABARITO
- B)Osmotic diuresis due to hyperglycemia
- C)Collecting duct resistance to ADH
- D)Increased renal sensitivity to aldosterone
- E)Excess secretion of atrial natriuretic peptide
Explicação
This patient has central diabetes insipidus after pituitary surgery. Low urine osmolality with hypernatremia and a brisk response to desmopressin indicates inadequate ADH secretion rather than renal resistance. ADH is synthesized in the hypothalamus and releas... Ver explicação completa e trilha adaptativa →