A 10-year-old girl is admitted to the Paediatric ICU after a car accident with extensive head trauma. 12 hours after being admitted she develops increased urine output, 100 ml/h (s... A 10-year-old girl is admitted to the Paediatric ICU after a car accident with extensive head trauma. 12 hours after being admitted she develops increased urine output, 100 ml/h (see lab results). Temperature 36.9°C, Heart rate 102/min, Blood pressure 120/70 mmHg, Respiratory rate 18/min, Serum osmolality 326 mmol/kg (280-300 mmol/kg), Urine osmolality 90 mOsm/Kg H20 (280-910 mOsm/Kg H20). Which of the following is the most likely diagnosis? A. Central diabetes insipidus B. Nephrogenic diabetes insipidus C. Excessive intravenous fluid administration D. Syndrome of Inappropriate Antidiuretic Hormone Secretion
Understand the Problem
The question presents a clinical scenario of a 10-year-old girl admitted to the Paediatric ICU after a car accident with head trauma. The girl exhibits increased urine output and the question asks to determine the likely diagnosis based on the clinical information and lab results provided.
Answer
The final answer is A. Central diabetes insipidus
The most likely diagnosis is central diabetes insipidus, which is caused by decreased secretion of antidiuretic hormone (ADH) after head trauma.
Answer for screen readers
The most likely diagnosis is central diabetes insipidus, which is caused by decreased secretion of antidiuretic hormone (ADH) after head trauma.
More Information
Central diabetes insipidus (CDI) is a possible complication of traumatic brain injury (TBI). It results from the reduced secretion of vasopressin, which impairs the kidney's ability to reabsorb water, leading to increased urine output and dilute urine.
Tips
A common mistake is confusing diabetes insipidus with diabetes mellitus. Diabetes insipidus involves ADH and water balance, whereas diabetes mellitus involves insulin and glucose metabolism.
Sources
- Central diabetes insipidus in pediatric severe traumatic brain injury - pubmed.ncbi.nlm.nih.gov
- Diabetes Insipidus after Traumatic Brain Injury - PMC - pmc.ncbi.nlm.nih.gov
- Head injury - Trauma Service - The Royal Children's Hospital - rch.org.au
AI-generated content may contain errors. Please verify critical information
