Question

Rita is a 105 pound 19 year-old college student who, as part of a sorority hazing ritual, attempted to drink 2 gallons of water over a 1 hour period. She made it through 1.5 gallons before she began vomiting, became disoriented, and started slurring her speech. Others at the party didn’t think much of her behaviors, until she collapsed and began having seizures. 911 was called and she was rushed to the hospital. In the emergency room, Rita was semi-comatose, responding only to painful stimuli. Her vital signs were stable, and a review of other systems noted no abnormalities. Blood and urine labs were ordered, with the following results:

Na+: 109 mEq/L K+: 4.0 mEq/L Chloride: 88 mEq/L CO2: 20 mEq/L Blood urea nitrogen (BUN): 9 mg/dL Creatinine: 1.0 mg/dL Glucose: 105 mg/dL Serum osmolality: 229 mOsm/kg H2O Urine osmolality: 80 mOsm/kg H2OQuestions (1 point each)1. List Rita’s abnormal lab values, along with their normal ranges

.2. What 2 conditions is Rita simultaneously suffering from?

3. What lab values support these diagnoses?

4. This condition can cause brain damage secondary to cerebral edema. Explain, in detail, the mechanism by which cerebral edema occurs in the setting of these diagnoses.

5. What will the treatment be for this patient?

Answer 1

1.

2.From the comparison of the above values it is clearly seems that Rita simultaneously fuffering from HYPONATREMIA and WATER INTOXICATION. HYPONATREMIA is a symptom of lower Na+ level in blood plasma. WATER TOXICATION is the side effects in the body due to high level of water intake.

3. The lab values that support these diagnosis are abnormal values of Na+ ion in blood plasma, abnormal values of serum and urine osmolality in comparison with the normal values.

4. Associates, the glial cell of brain uptakes water and swell as the high osmolality in the extra cellular fluid in case of Rita. It has special types of channels named aquaporin. But osmotic pressure in normal condition is maintained by Na+K+ pump, which incorporates Na+ ion in the glial cell and make the cytosol hypersonic in comparison with its environment, extracellular fluid.

5. Three are mainly two types of treatment

a. Intravenous injection of Na+ ion.

b. Taking some medicine, anticholinergic drug like Trospium, Tolterodine which increases the volume of urine.