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NBME 21 Answers

nbme21/Block 4/Question#10 (42.3 difficulty score)
A 64-year-old man is evaluated for cough, ...
tags: SIADH hyponatremia renal 

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submitted by haliburton(196),
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Salml clel ugln rcaecn aescus ASHID. taniooLc + eyxsincuolra uscle.

mcl  To expand, SIADH may also result in euvolemic hyponatremia. This is because, as we know, ADH increases absorption of water and therefore initially results in an increased circulating volume. However, this results in increased stretch of the atria and subsequent secretion of ANP. ANP (atrial natriuretic peptide) then results in loss of sodium and water. +10  

submitted by kchakhabar(37),
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hWta rehwt me fof ni isht sqnteuoi is eht aephrs eclls" wtih tiltel ptsmolcya ahtt aer witce the ezsi of spmcto.yh"ely I oguhht slalm" lelc acan"mcori nonatc eb thta .ibg

nala_ula  Omg literally the same thought process I had, that phrase through me off! +  
nala_ula  threw* +1  
jesusisking  Super counter-intuitive but apparently SCC cells are 1.5-4x the size of lymphocytes: +1  

submitted by hello(257),
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ehT pnetita sah c"lsel rgndraae ni rlfttgiianni sthse"e -;-g&t itisandec nantgiaml ncecra lsc.le

The cllse aer reihtne augalrnld nor ussoquam ;gt-&- the crcnea si neeitrh amanoocdianrec rno suuaoqsm clel lgnu rcnce,a ilse.eetprvyc

hiTs asleve lasml toa lcel lung er.cnca SIDHA is het msot ocnmmo poeacsnltraapi mnorysed rof masll ato cell glun encrac tg-&-; aleds ot erhatipm.aoyn

submitted by ergogenic22(250),
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hwy si aldphiyepriiem rcnydeoas ot uichngs soredynm otn a iipi?oblssyt

hello  SIADH = MC paraneoplastic syndrome of small oat cell lung cancer. Also, Cushing syndrome would cause would weight gain, skin hyperpigmentation, and hypokalemia. Not, lyperlipidemia. +1  
charmrooftops  You do get hyperlipidemia in cushing though? So still unsure why this is not a possibility. Is it just a "more common" thing for SIADH? +2  
peridot  I was debating the same thing. But yeah I guess the SIADH association is just supposed to be stronger somehow and "more common"? +