A 66-year-old man with newly diagnosed small cell lung carcinoma presents with confusion and nausea. Vital signs show BP 128/76 mmHg, HR 88/min, RR 16/min, temperature 37.2°C, and SpO2 98% on room air. Physical examination reveals euvolemia with no edema or jugular venous distension. Serum sodium is 118 mEq/L with inappropriately elevated urine osmolality of 650 mOsm/kg and low serum osmolality of 265 mOsm/kg. Which of the following is the most likely diagnosis?

  1. A)Central diabetes insipidus
  2. B)Hyperaldosteronism
  3. C)Syndrome of inappropriate ADH secretionGABARITO
  4. D)Adrenal crisis
  5. E)Primary polydipsia

Explicação

SIADH causes euvolemic hyponatremia with inappropriately concentrated urine because excess ADH retains free water. Small cell lung carcinoma is a classic ectopic source. Ver explicação completa e trilha adaptativa →

Fazer o diagnóstico grátis de USMLE