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NBME 19 Answers

nbme19/Block 2/Question#6 (6.0 difficulty score)
24 yo man, generalized tonic-clonic seizure; ...
Psychogenic polydipsiaπŸ”,πŸ“Ί

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submitted by an_improved_me(16),

I guess a couple of key things are:

He is hyponatremic and shows signs of hyponatremia (tonic-clonic seizures, somnolence.

He shows signs of over-hydration (low specific gravity of urine, and low urine osmols).

He then is placed on fluid restriction, but breaks the test by not following doc orders.

The question isn't tricky so much by what it's asking, but more based on what it isn't telling. It does not tell you his fluid status, his urine ouput, his fluid input, what meds he is given, etc.