A 21-year-old woman presents to the ED confused and agitated 3 hours after taking MDMA at a nightclub. Vital signs show temperature 39.2°C, heart rate 128/min, blood pressure 148/92 mmHg, and respiratory rate 20/min. She subsequently experiences a generalized tonic-clonic seizure. Laboratory studies reveal severe hyponatremia (Na+ 118 mEq/L) and elevated urine osmolality. Urine drug screen is positive for amphetamines. Which mechanism best explains the electrolyte abnormality associated with this drug?
- A)Loop diuretic use
- B)Inhibition of carbonic anhydrase
- C)Distal renal tubular acidosis
- D)Aldosterone deficiency
- E)SIADH with excess free water intakeGABARITO
Explicação
MDMA can cause serotonin and catecholamine excess, hyperthermia, and SIADH, and club settings may lead to excessive water intake. The combination can produce severe hyponatremia and seizures. Ver explicação completa e trilha adaptativa →