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Category: Critical Care Medicine-Endocrine Disorders--->Parathyroid and Calcium
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Question 6#Print Question

A 22-year-old previously healthy female is brought to the emergency department from a rave party with a chief complaint of “dizziness.” Per her friends, the patient had taken a tablet of “ecstasy.” There was no report of other drug use or excessive water intake. Her blood pressure is 108/62 mm Hg, pulse 115 beats/min, respiration rate 18 breaths/min, pulse oximetry 98% on room air, and afebrile. Physical examination demonstrates normal skin turgor, normal cardiac examination, clear lungs, no edema, and nonfocal neurologic examination. Head CT and chest X-ray are negative. Her labs are:

  • sodium 128 mEq/L
  • potassium 3.7 mEq/L
  • chloride 87 mEq/L
  • bicarbonate 19 mEq/L
  • urea nitrogen 6 mg/dL
  • creatinine 0.7 mg/dL
  • glucose 118 mg/dL
  • Measured serum osmolality is 250 mOsm/kg
  • Urine sodium is 105 mEq/L
  • urine osmolality is 352 mOsm/L

Alcohol level is 0 and toxicology screen is negative.

What is the next best step in management?

A. Neurosurgical consult
B. Administration of hypertonic saline
C. Demeclocycline
D. Fluid restriction




Category: Critical Care Medicine-Endocrine Disorders--->Parathyroid and Calcium
Page: 2 of 2