Endocrine System Disorders Q 4 - Gyan Darpan : Learning Portal
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Sunday, 10 April 2022

Endocrine System Disorders Q 4

Which of these signs suggests that a male client with the syndrome of inappropriate antidiuretic hormone (SIADH) secretion is experiencing complications?
    A. Tetanic contractions
    B. Neck vein distention
    C. Weight loss
    D. Polyuria

Correct Answer: B. Neck vein distention

SIADH secretion causes antidiuretic hormone overproduction, which leads to fluid retention. Severe SIADH can cause such complications as vascular fluid overload, signaled by neck vein distention. Physical examination should include assessment of volume status, as these patients are typically euvolemic. Skin turgor and blood pressure are within the normal range. Moist mucous membranes with no evidence of jugular venous pulsation or edema typically indicate euvolemia.

Option A: This syndrome isn’t associated with tetanic contractions. Clinical manifestations of SIADH can be due to hyponatremia and decreased ECF osmolality, which causes the water to move into the cells causing cerebral edema. Signs and symptoms depend upon the rate and severity of hyponatremia and the degree of cerebral edema.
Option C: It may cause weight gain and fluid retention (secondary to oliguria). History must include inquiry about head injury, chronic pain, smoking, weight loss, pulmonary symptoms, drug intake, or substance abuse (particularly heroin and ecstasy), in addition to all the above-mentioned symptoms. The clinicians should evaluate the source of excess fluid, and the chronicity of the condition merits consideration.
Option D: Chronic hyponatremia allows cerebral adaptation, and the patients remain asymptomatic despite a serum sodium concentration below 120mmol/L. Nonspecific symptoms like nausea, vomiting, gait disturbances, memory, cognitive problems, fatigue, dizziness, confusion, and muscle cramps can occur with chronic hyponatremia.

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