5. Spankophilus J. Weaselsnot is a 68-year-old man recently diagnosed with a spe

Question

5. Spankophilus J. Weaselsnot is a 68-year-old man recently diagnosed with a specific kind of lung cancer that results in unregulated release of ADH from the tumor. (This is an example of ectopic hormone secretion; ectopic = in, or from, an abnormal place. Obviously, ADH normally comes from the posterior pituitary, so ADH coming from cells in the lungs would be ectopic.) Because the ectopic release is unregulated, levels of the hormone can become quite high. Table 1 reports selected values from a recent visit to his physician. Table 1- Laboratory results for Mr. Weaselsnot. His systemic blood pressure was normal. 112 mEq/L 230 mOsm/L 1125 mOsm/L (normal: 140 mEq/L) (normal: 290 mOsm/L) Plasma Na Plasma osmolarity Urine osmolarity (a) Explain Mr. Weaselsnot's urine osmolarity. (3 points) (b) Why was Mr. Weaselsnot's plasma Na" concentration so low? (3 points) (c) What was happening to the volume of Mr. Weaselsnot's total body water (ECF and ICF combined)? Explain. (5 points) (d) What would happen to the volume (size) of Mr. Weaselsnot's cells? Explain. (7 points) (e) Interestingly, Mr. Weaselsnot's blood pressure was normal. How could that be? (5 points)

Explanation / Answer

a.

Here the patient is suffering from hypoosmolarity. Due to hyper secretion of ADH the excretion of water decreases thereby decreasing the osmolarity of body fluid.

b.

sodium concentration was low because of more water retained in the body. So the sodium concentration is low compared to water level in body.

c.

Volume of total body water increased due to decreased water excretion. when water retention is decreased the water distributed betwen extra and intra cellular compartment also increases. So body water is distributed equally.

d.

since the intra cellular fluid increases the cell volume increases and results in confusion, delirium and other neurologic abnormalities

e.

When blood volume is increased the blood pressure is increased but the baroreceptors sense the change and regulate blood pressure by reflex mechanism and hence blood oressure will be normal.

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