Posted: July 24th, 2017
Hospital discharge of a 75-year-old man is
delayed due to unavailability of a bed in a
nursing home. He is bedridden and unable to
attend to his personal needs. During a 3-day
period, his pulse increases from 82/min to
125/min, and blood pressure decreases from
124/72 mm Hg to 100/55 mm Hg. Laboratory
values include:
Day 1 Day 3
Hemoglobin 16.4 g/dL 18.4 g/dL
Serum
Urea nitrogen 18 mg/dL 56 mg/dL
Glucose 100 mg/dL 89 mg/dL
Na+
135 mEq/L 151 mEq/L
Creatinine 1.1 mg/dL 1.2 mg/dL
Which of the following is the most likely
diagnosis?
(A) Acute renal failure
(B) Dehydration
(C) Diabetic ketoacidosis
(D) Gastrointestinal hemorrhage
(E) Syndrome of inappropriate ADH
(vasopressin)
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