question1111111111111111111111 - faster

[ArchivalUser]

5-year-old girl weighing 18 kg is brought into the emergency room. Her urine osmolality
is 310 mOsm/L, and her parents say that she has a daily urine output of about 4 liters.
The most likely diagnosis is:
A. excessive urination caused by drinking too many sweetened soft drinks
B. nephrogenic drinking syndrome
C. syndrome of inappropriate ADH secretion (SIADH)
D. diabetes insipidus
E. diabetes mellitus

[ArchivalUser]

E. Urine osmolarity is increased.

[ArchivalUser]

eee

[ArchivalUser]

E.

[ArchivalUser]

Agree w/ EEe Because
Large volume of urine and low osmolarity = Diabetes Insipidus
Small Volume of urine and high osmolarity = SIADH
Large volume of urine and high osmolarity = DM

[ArchivalUser]

Yup E

[ArchivalUser]

E

IS THE ANSWER
ariadnac06 EXPLANATION IS RIGHT

[ArchivalUser]

Guys I am just confused about this q.The normal urine osmolality is 500-800mOsm ??am i wright? so 310 mOsm/L, is low
Ans??? diabets inspidus

[ArchivalUser]

hi star78 (i have just learned this because u raised the question--thanx)

ultra filtrate at Bowman capsule has the same osmolarity as of plasma(300 mosm/L)
so the urine osmolarity ranges:
300 mosm/L(B.capsule)------------>1200 mosm/L (max in the presence of ADH at collecting T.)

But normaly urine osmolarity is 400---800 (some books mention lil different but arround that range).

NOTE:
In "Water Diuresis" (psychogenic polydipsea and D.Insipidus) the Urine Osmo. is always below plasma osmo. i.e. < 285 (usually < 200)

"Solute Diuresis" urine osmo. is above plasma osmol. i.e. > 290
identifying the solute help in the Dx:
1-Na---increase intake,Diuretic Tx
2-Glucose--D.Mellitus
3-Urea-----Hypercatabolic state,Renal disease

so the refrence point is arround 300 mosm/L
< 300 mosm/L----Water Diuresis
> 300 mosm/L----Solute Diuresis

[ArchivalUser]

thanxs sarim
I got it!!!!