share email twitter ⋅ join discord whatsapp(2ck)
free120  nbme24  nbme23  nbme22  nbme21  nbme20  nbme19  nbme18  nbme17  nbme16  nbme15  nbme13 

NBME 20 Answers

nbme20/Block 1/Question#19 (38.6 difficulty score)
A 60-year-old man comes to the physician ...
Urine Na+: increased; Serum osmolality: decreased🔍
tags:

Login to comment/vote.


 +7 
submitted by hayayah(1056),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

ihTs apitnet sha llasm cell .cmicnoraa hiTs type of cacren si sdcestioaa whti rapsplnaeactio rnosesdmy usch :sa hgCnusi ydoSm,nre DSAHI, ro aobneidtis sintaag 2a+C lnascnhe )at(rLmao-tebEn or oe.rsnun mitofcilniApa of mcy enoecsgno is sola ocnom.m

IDASH e(mrnodSy of aepraorpintpi ntreuciatdii hrenomo ctos)riene is cecahizatredr y:b

  • xEeesicvs rfee ewrat etitronen
  • vmcuEeloi aethpyniomar hwti niuerncdyuinrtoa aN+ econrxeti
  • nerUi iaotlymosl &;gt erums tylooilsma

odyB sopserdn ot wtera orttenine tihw dstlroenoae dna ANP dan P.BN Tath is wtha ucesas hte icasnerde ynairur +Na eneiotrsc chhiwŽ easld ot mlazaoiotnnri of lcurllartxeae lfdui voeuml dŽan eth vieomecul orpeynhaim.ta

hello  Why would body respond to water retention with ALDO? ALDO would increase water retention... +6  
nala_ula  @hello, the body's response is to decrease Aldosterone since there is increased volume retention and subsequently increased blood pressure. This concept confused me a lot, but I ended up just viewing it as separate responses. First, the increased volume retention leads to increase ANP and BNP secretion that lead to decreased Na+ reabsorption in the tubules (page 294 in FA 2019) and second, this increased volume basically leads to increased pressure so lets also decrease aldosterone so there is no Na+ retention (since water comes with it)... I thought it was counterintuitive to secrete so much Na+ since you're already having decreased serum osmolality (decreased Na+ concentration) because of the water retention, but I'm guessing that this is just another way our body's well intentions end up making us worse XD +32  
compasses  see page 344 FA2019 for SIADH. +  
dickass  author pasted text straight from FA but the arrows didn't copy over, inverting the original meaning +3  
medninja  The idea of increasing urine Na is getting rid of water, thats why this mechanism end increasing urine Na secretion even when there are very low serum Na levels. +  



 +2 
submitted by dickass(84),
unscramble the site ⋅ remove ads ⋅ become a member ($39/month)

S+AHDI: eExcssiev erfe warte oie en+ttrn uvclmeioE tineahpmyora tihw uecnditno raniyru aN ox+rene tci enUir llomtioasy ;> rmseu oliyamltso

Body esdopsrn ot awrte neienortt AEESC DtwERihD esrelntooda and RAEIDCSEN NPA and PNB

rateW reetotnin t&=;g Less onrldtaseeo ;t=&g sseL CENA heaclnns g=&t; essL idumos apurekte t;&g= Loss fo sudoim ni uiern