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Comments ...
aneurysmclip
could be due to increased blood volume leading to secretion of ANP and thus natriuresis which would normalize serum sodium levels?
that's the only reason I could think of
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dysdiadochokinesia
My guess is that the sodium and water loss from 21a-hydroxylase deficiency would result in increased RAAS activation and production of Angiotensin II (AGII). Recall that AGII affects the PCT by upregulating Na/H+ exchangers, allowing for there Na/H2O to be resorbed, thus partially counteracting the impact of aldosterone deficiency at the collecting duct. However, I'm not sure if the effect of AGII on the PCT is great enough to entirely counterbalance the loss of aldosterone to present with normal sodium levels.
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Subcomments ...
why is the Na normal in this patient? Everything else made sense, the high K and 17 hydroxyprogesterone.