NBME Step 2 CK Form 7 Psychogenic polydipsia (NBME Answers)

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Retired NBME Step 2 CK Form 7 Answers

step2ck_form7/Block 3/Question#36 (reveal difficulty score)
A 72-year-old man comes to the physician for ...
Psychogenic polydipsia 🔍 / 📺 / 🌳 / 📖
tags: psych

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submitted by ∗step_prep5(246)

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Older patient who has been drinking 12-15 glasses of water daily and has a history of schizoaffective disorder found to have hyponatremia with low urine sodium and low urine osmolality, most consistent with psychogenic polydipsia
Key idea: Despite UWorld claims, urine osmolality does NOT need to be below 100 to diagnose psychogenic polydipsia
Key idea: Antipsychotics can commonly lead to dry mouth (as is seen in this patient), making a patient feel thirsty

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lindasmith462 so is psychogenic polydipsia always the term we use? I was taught that it was a specific subtype of "primary polydipsia" and isn't necessarily used for patients who drank alot of water for a "reason" (like this guy who just thinks he needs to drink this much to prevent an infection and didn't have this behavior before his infxn regardless of his schizoaffective disorder) +

sheska clearly this people dont know the definition of euvolemia (clear mucuous membrane) psychogenif polydipsia presents with euvolemia. tssss nbme +3

charcot_bouchard I think i ruled out this just seeing dry mucosa. +

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submitted by ∗charcot_bouchard(574)

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Adrenal Insuff - No. Normal K & HCO3. Also normal BP.

Adverser effect of FQ - It doesn't cause anything like this. SIADH causing drugs are SSRI, Cabamazepam, Cyclophosphamide

DI - Would cause mild hypernatremia

SIADH - (the one I chose,,,dk what kind of drug I was on) is also ruled out for one there's no indication of that duh. second the Uosm < Sosm here. 200 vs (2x122 i.e 244+ )

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