Endocrinology A female in her early 20’s recently notices that she has to get up
ID: 3517019 • Letter: E
Question
Endocrinology
A female in her early 20’s recently notices that she has to get up two or more times a night to urinate. Soon thereafter she notices she has to urinate much more frequently during the day as well, up to every two hours. Because she assumed her increased trips to the bathroom were a result of her caffeinated soda beverage drinking, she stopped drinking her twice daily Pepsi. However, even after this she still notices the same symptoms of frequent urination. She also notices that her urine is more colorless or pale in appearance. After running some tests you see her blood osmolarity is 308 mOsm/L and her urine is 175 mOsm/L. You come to the conclusion that of one of three diseases is likely affecting her. To make an accurate diagnosis you perform another urine test and a blood test on her. Tell me at least two diseases she could potentially have and what you would examine in the urine and blood to make a positive diagnosis to discriminate between these two (e.g. what would you see in the blood and urine that would be different for each disease in order to distinguish between them).
Explanation / Answer
Apart from many inflammatory conditions, polyuria with hypo osmolaric urine may be a result of ADH deficiency or Diabetes insipedus.
Now, we perform blood and urine test and look for salts in urine and ADH hormone concentration in blood. If we find disturbed salt balance in urine, we conclude Diabetes insipedus. If we find lowered ADH in blood- we conclude ADH deficiency.
If glucose is seen in urine, we may conclude diabetes mellitus.
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