A 19-year-old woman underwent transsphenoidal pituitary surgery for a Rathke cleft cyst 1 month ago. She now presents with sudden-onset polydipsia, polyuria (6 L/day), and nocturia. Vital signs show BP 118/76, HR 88, RR 16, Temp 37°C. Labs reveal plasma osmolality 295 mOsm/kg, urine osmolality 95 mOsm/kg, and serum sodium 142 mEq/L. She denies fever or headache. Which intervention is most appropriate immediately?
- A)Observation without intervention; symptoms typically resolve spontaneously
- B)Hyperetonic saline infusion
- C)Fluid restriction to 1 liter per day
- D)Desmopressin (DDAVP) replacement therapyGABARITO
- E)Thiazide diuretics to reduce polyuria
Explicação
Central diabetes insipidus (CDI) is a common post-transsphenoidal surgery complication from vasopressin-producing neuron disruption. The high plasma osmolality (295) with inappropriately dilute urine (95) confirms vasopressin deficiency. DDAVP replacement is t... Ver explicação completa e trilha adaptativa →