A 31-year-old woman presents with polyuria and intense polydipsia two weeks after transsphenoidal pituitary adenoma resection. Vital signs show HR 98/min, BP 138/82 mmHg, RR 16/min. Serum sodium is 151 mEq/L with serum osmolality of 310 mOsm/kg. Urine osmolality is 185 mOsm/kg. She denies recent medication changes and takes no diuretics. Following desmopressin administration, urine osmolality increases to 580 mOsm/kg. Which diagnosis best explains these findings?

  1. A)Nephrogenic diabetes insipidus
  2. B)Central diabetes insipidusGABARITO
  3. C)Type 4 renal tubular acidosis
  4. D)Syndrome of inappropriate antidiuretic hormone secretion
  5. E)Primary polydipsia

Explicação

This patient has central diabetes insipidus due to deficient ADH release after pituitary surgery. A marked rise in urine osmolality after desmopressin confirms intact renal responsiveness to ADH. Ver explicação completa e trilha adaptativa →

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