]> 2026-07-31T16:29:06+00:00 WBR0212 0 en Mineralocorticoid deficiency Advanced renal failure SIADH '''Correct'''-The patient has a euvolemic hypotonic hyponatremia secondary to inappropriate antidiuretic hormone secretion (SIADH). SIADH has a persistently elevated ADH level in the absence of an appropriate stimulus. NSAID’s potentiate the action of ADH and thus it is a cause of SIADH. Before SIADH diagnosis, it is appropriate to rule out hypothyroidism and adrenal insufficiency. The diagnostic test is the simultaneous measurement of serum and urine osmolality, which will be low (<285 mOsm/Kg of water) and inappropriately high (>300 mOsm/Kg of water) respectively. The low serum uric acid (<3.6 mg/dl in men) is due to hemodilution. Nephrogenic diabetes insipidus Neurogenic diabetes insipidus Community Medical Health Center Primary Care Office Inpatient Facilities Vendhan Ramanujam A 84 year old man is referred from his nursing home for evaluation of confusion and lethargy. He is a known rheumatoid arthritis patient, who is currently using indomethacin and methotrexate. His temperature is 36.8 C, pulse is 72/min, blood pressure is 110/70 mm Hg and respirations are 16/min. He is disoriented. Mucus membranes are moist. Neck examination reveals no jugular venous distension. Lungs are clear on auscultation. Abdomen is soft, nontender and not distended. His laboratory results are significant for a serum sodium level of 118 mEq/L (Normal 135 mEq/L to 148 mEq/L). Other test results are<br> Potassium 3.9 mEq/L<br> Glucose 98 mg/dL<br> BUN 9 mg/dL<br> Uric acid 3 mg/dL<br> Serum osmolality 260 mOsm/Kg of water<br> Urine osmolality 450 mOsm/Kg of water<br> Urine sodium 80 meq/L<br> <br> What is the most likely cause? C Endocrine Electrolytes 2020-10-27T23:47:04Z 2459150.4910185 WBR0212