A 44-year-old man with bipolar disorder on lithium for 5 years presents with polydipsia and polyuria. Vital signs: BP 138/85, HR 92, RR 16, Temp 37°C, SpO2 98%. Serum sodium is 150 mEq/L; serum creatinine 1.4 mg/dL. Urine osmolality remains 280 mOsm/kg despite water deprivation and desmopressin administration. Thyroid function tests are normal. Which medication most likely caused this nephrogenic diabetes insipidus?
- A)Spironolactone
- B)Hydrochlorothiazide
- C)Acetazolamide
- D)Desmopressin
- E)LithiumGABARITO
Explicação
Lithium is correct. Nephrogenic diabetes insipidus results from renal resistance to ADH, so urine remains dilute despite water deprivation and desmopressin administration. Lithium commonly disrupts collecting duct responsiveness to ADH and causes polyuria, pol... Ver explicação completa e trilha adaptativa →