81. A 58-year-old man who is a construction worker comes to the office because of a 1-week history of pain on the right side of his head. One week ago, he says his head on a beam while carrying drywall to the second floor of a house under construction. He has had dry mouth, excessive thirst, and increased urinary fre during this period. His pulse is 120 /min, respirations are 25/min, and blood pressure is 120/65 mm Hg. Physical examination shows dry mouth and decrease turgor. Urine osmolality is 196 mOsmol/kg H₂O (N>287). An MRI of the brain shows a hyperintense sighal consistent with hemorrhage of the posterior pituitam This patient most likely has decreased renal reabsorption of which of the following? A) Chloride ions OB) Magnesium ions C) Potassium ions D) Sodium ions E) Water

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**Case Study: Renal Reabsorption Post-Trauma**

**Patient Overview**:
- **Age**: 58 years old
- **Occupation**: Construction worker
- **Presenting Complaint**: 
  The patient reports a 1-week history of pain on the right side of his head. A week prior, he struck his head on a beam while carrying drywall to the second floor of a house under construction.

**Symptoms**:
- Dry mouth
- Excessive thirst
- Increased urinary frequency over the past week

**Vital Signs and Physical Examination**:
- **Pulse**: 120/min
- **Respirations**: 25/min
- **Blood Pressure**: 120/65 mm Hg
- Physical examination reveals dry mouth and decreased skin turgor.

**Laboratory and Imaging Findings**:
- **Urine Osmolality**: 196 mOsmol/kg H₂O (normal > 287)
- **MRI Results**: Hyperintense signal consistent with hemorrhage of the posterior pituitary gland

**Clinical Question**:
This patient most likely has decreased renal reabsorption of which of the following?

**Options**:
A) Chloride ions  
B) Magnesium ions  
C) Potassium ions  
D) Sodium ions  
E) Water 

**Answer and Explanation**:
- **Correct Answer**: E) Water

Following the trauma, the patient exhibits signs of dry mouth, excessive thirst, frequent urination, and decreased skin turgor, all of which suggest a condition known as Diabetes Insipidus. This condition often results from damage to the posterior pituitary gland, which can interfere with the secretion of antidiuretic hormone (ADH). Low ADH levels lead to decreased water reabsorption in the kidneys, resulting in dilute urine (low urine osmolality) and elevated urinary frequency. Consequently, this patient most likely has decreased renal reabsorption of water.
Transcribed Image Text:**Case Study: Renal Reabsorption Post-Trauma** **Patient Overview**: - **Age**: 58 years old - **Occupation**: Construction worker - **Presenting Complaint**: The patient reports a 1-week history of pain on the right side of his head. A week prior, he struck his head on a beam while carrying drywall to the second floor of a house under construction. **Symptoms**: - Dry mouth - Excessive thirst - Increased urinary frequency over the past week **Vital Signs and Physical Examination**: - **Pulse**: 120/min - **Respirations**: 25/min - **Blood Pressure**: 120/65 mm Hg - Physical examination reveals dry mouth and decreased skin turgor. **Laboratory and Imaging Findings**: - **Urine Osmolality**: 196 mOsmol/kg H₂O (normal > 287) - **MRI Results**: Hyperintense signal consistent with hemorrhage of the posterior pituitary gland **Clinical Question**: This patient most likely has decreased renal reabsorption of which of the following? **Options**: A) Chloride ions B) Magnesium ions C) Potassium ions D) Sodium ions E) Water **Answer and Explanation**: - **Correct Answer**: E) Water Following the trauma, the patient exhibits signs of dry mouth, excessive thirst, frequent urination, and decreased skin turgor, all of which suggest a condition known as Diabetes Insipidus. This condition often results from damage to the posterior pituitary gland, which can interfere with the secretion of antidiuretic hormone (ADH). Low ADH levels lead to decreased water reabsorption in the kidneys, resulting in dilute urine (low urine osmolality) and elevated urinary frequency. Consequently, this patient most likely has decreased renal reabsorption of water.
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