Thomas L. a 28-year-old male, complained of abrupt polydipsia and polyuria. Bloo

Question

Thomas L. a 28-year-old male, complained of abrupt polydipsia and polyuria. Blood and urine analyses provided the following results:

Fasting blood glucose 93 mg/dL

Serum sodium 145 mEq/L

Serum potassium 2.8 mEq/L

Urine osmolality <200 mOsm/L

Urine volume 15 L/day

Urine glucose 0

Water deprivation and hypertonic saline infusion was used to treat and the treatment did not cause a significant reduction in the polyuria and concentration of urine. Complete water-deprivation results in the following: Urine osmolality 225 mOsm/L. However, there is a significant concentration of the urine and a decrease in urinary output following administration of ADH.

2. Why did the water deprivation and hypertonic saline infusion not result in a concentrated urine?

3. Identify the disorder and describe the location of the disorder in Thomas.

4. Thomas was given a nasal spray containing a synthetic substance to self-administer to treat this condition. What type of compound was present in the nasal spray?

5. What is the long-term prognosis for Thomas L?

Explanation / Answer

Answer:

2. Water deprivation and hypertonic saline fusion do not cause a significant reduction in the polyuria and concentration of urine because kidneys are unable to respond to the extreme water intake.

3. The disorder is due to the deficiency of vasopressin (ADH). The location of the disorder is hypothalamic -neurohypophyseal tract, from where the vasopressin is released.

4. A nasal spray containing a substance with ADH.

5. The medication used to treat this disorder is called desmopressin acetate (DDAVP), which is similar to the hormone antidiuretic hormone (ADH), also called vasopressin.

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