A 70-year-old woman with chronic hyponatraemia (Na 125 mmol/L) is asymptomatic and euvolaemic. Investigations suggest syndrome of inappropriate antidi...

Question

A 70-year-old woman with chronic hyponatraemia (Na 125 mmol/L) is asymptomatic and euvolaemic. Investigations suggest syndrome of inappropriate antidiuretic hormone secretion (SIADH). What is the most appropriate initial management?

Accepted Answer

Fluid restriction and treatment of underlying cause

Answer

Rapid correction with hypertonic saline aiming for normal sodium within 12 hours

Answer

High-dose loop diuretics and salt tablets without fluid restriction

Answer

No treatment is required for asymptomatic hyponatraemia

Answer

Immediate demeclocycline therapy in all cases

au-racp MCQ (SBA): Chronic SIADH management

A 70-year-old woman with chronic hyponatraemia (Na 125 mmol/L) is asymptomatic and euvolaemic. Investigations suggest syndrome of inappropriate antidiuretic hormone secretion (SIADH). What is the most appropriate initial management?