A patient with known cranial diabetes insipidus is obtunded with blood pressure 82/48 mmHg, sodium 164 mmol/L and urine output 80 mL/hour. His last

Question

A patient with known cranial diabetes insipidus is obtunded with blood pressure 82/48 mmHg, sodium 164 mmol/L and urine output 80 mL/hour. His last desmopressin dose is uncertain. Which sequence is safest?

Accepted Answer

Restore circulation, then coordinate free-water replacement with monitored desmopressin therapy

Answer

Start 5% dextrose at maximum rate before correcting intravascular depletion

Answer

Restrict all fluid because absent polyuria excludes active diabetes insipidus

Answer

Give repeated desmopressin immediately until urine output stops, then assess volume status

Answer

Correct sodium to below 145 mmol/L within 6 hours using hypotonic saline boluses

Post-gestational diabetes follow-up — SCE Endocrinology MCQ

A patient with known cranial diabetes insipidus is obtunded with blood pressure 82/48 mmHg, sodium 164 mmol/L and urine output 80 mL/hour. His last desmopressin dose is uncertain. Which sequence is safest?