drzedI think the initial hyperchloremia would be quickly diluted out by the large consumption of water, so those two competing processes would likely neutralize the chlorine level, or even make the child hypochloremic. +2020-02-01T03:24:54Z
thisisfine Agreed! It's along the lines of those marathon runners who collapse questions. Nothing but water for 24 hours = getting rid of too much sodium. +12019-07-01T20:08:13Z
temmyare we just going to ignore the diarrhea for 3 days? what is its significance+12019-07-10T21:02:25Z
kardTemmy, We aint Ignoring the Diarrhea, Actually the most likely electrolytes to get lost with it is sodium> chloride> potassium> bicarbonate... Plus the Water intoxication -> HYPONATREMIA+12019-07-12T21:33:24Z
saulgoodmanBecause glucose is not an electrolyte, it does not conduct electricity in solution. The question is asking "Which of the following electrolyte abnormalities". +2020-02-03T17:46:10Z
charcot_bouchardthis is the problem bet uw and nbme. in uw it would be for sure a gotcha ques. but in nbme they are usually looking for most obvious. also look what they are asking "most likely". baby would dev low Na before acidosis. Thats my 2 cents+52019-06-10T07:52:52Z
temmyhyperchloremia will not account for the seizure that brought the patient to the hospital. seizures according to first aid is caused by hypocalcemia and hyponatremia+2019-07-10T21:09:26Z
cry2mucheverydayChildren with diarrhoea who drink large amounts of water or other hypotonic fluids containing very low concentrations of salt and other solutes, or who receive intravenous infusions of 50% glucose in water, may develop hyponatraemia. This occurs because water is absorbed from the gut while the loss of salt (NaCl) continues, causing net losses of sodium in excess of water. The principal features of hyponatraemic dehydration are:
there is a deficit of water and sodium, but the deficit of sodium is greater;
serum sodium concentration is low (<130 mmol/l);
serum osmolality is low (<275 mOsmol/l);
the child is lethargic; infrequently, there are seizures.
cry2mucheverydayAlso, why is this being given formula...? May be lactase deficiency...which leads to osmotic diarrhea...leads to hyponatremia(goljan)
Aren't newborns supposed to be kept on exclusive breast milk till 6 months??+2019-07-14T17:37:13Z
hello@cry2mucheveryday Don't read too much into it. The fact that the baby is receiving formula isn't relevant to answering the Q.
Btw, not everyone breast feeds. Additionally, the Q wouldn't make much sense if it said "they ran out of breastmilk"...+12019-08-07T21:08:43Z
hello@cry2mucheveryday Being on formula then the parents running out of formula is more of a clue for water intoxication. This is typically the scenario that water intoxication presents.
However, I suppose if for some reason the baby was being breastfed and the parents switched to exclusively waterfeeding (and no other foods), then water intoxication would also result.+2019-08-07T21:16:27Z
helloThat answer choice is hypERchrloremia, not hypochloremia.+2019-08-07T21:05:00Z