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NBME 20 Answers

nbme20/Block 2/Question#34 (22.6 difficulty score)
A 28-year-old man has excessive thirst and ...
HypothalamusπŸ”
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 +2 
submitted by hayayah(1056),
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tP sha asbedeit i.snsudip

If ruien tcnetsecnoar thwi isitanmnoritda of AHD al,agon eht isynked era epssnrivoe nad eht beprolm si wthi HDA udoinprtoc ni hte mshyulophata or ealrsee ni hte t.ops autirip.yt

hello_planet  FA 2019 pg. 344 +2  
djeffs1  first aid (and my school) say if U-Osm doesnt increase by 50% or more, then its still nephrogenic. Not so according to NBME... +  



 +1 
submitted by sugaplum(323),
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sTeeh awlays itrpdep em :up
+ soapi=iPydl nseopsdr ot twaer raivnpo,edit low srmeu aN
+ lnr=teaC ednpssor to rvsssnpaieo, ighh rsemu Na
pNh+ocinegr e = neropdss to gtnh,oni mlrnao suemr aN

lynn  I think serum Na+ only depends on the patient's access to water. FA19 pg 344 says serum osm is high in both and doesn't mention Na specifically. Spent a while double checking for DI, but low serum Na for polydipsia is definitely correct. +  
drzed  In general, SIADH or polydipsia will cause HYPOnatremia, and DI (central or nephrogenic) will cause HYPERnatremia, but in the latter--as you stated--water access change the serum Na. +