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NBME 22 Answers
A 66-year-old man develops worsening shortness of ...
Dilution of serum sodium due to ADH (vasopressin) secretion
Sorry, hyponatremia* right?
My thinking is that ANP causes natriuresis, so you're losing salt and water at the same time (isoosmotic fluid?). Meanwhile, ADH absorbs only free water, so it would dilute the serum.
Correct me if i'm wrong.
Ohhh you are right. Thank you for the explanation! I got so fixated on that one mechanism haha.
Apparently, in chronic CHF you see hyponatremia. Because CHF causes a decrease in cardiac output and circulating blood volume, which in turn triggers a compensatory response aimed at preserving blood pressure. This stimulates the body to retain both water and sodium.
i agree with Hayayah... the RAAS system is activated due to poor perfusion to the kidney due to decomp heart failure.
if all else fails i hope i just drill this one statement in my brain and it comes out in the right way on test day thank u!!!
Hi Lauri, this is normal. We can't post the whole question due to copy right laws but you can almost always find the question you are looking for and the answer to by going to the form and then Ctrl + find -ing the age of the patient and other key words or the answer!
HI LAURI. THANK YOU FOR DEMONSTRATING YOUR PROFICIENCY WITH ALL-CAP COMPOSITION!