A 67-year-old smoker has cough, weight loss and confusion. CT chest shows a central hilar mass with mediastinal lymphadenopathy. Sodium is 119

Question

A 67-year-old smoker has cough, weight loss and confusion. CT chest shows a central hilar mass with mediastinal lymphadenopathy. Sodium is 119 mmol/L, serum osmolality is low, urine osmolality is high and urine sodium is 64 mmol/L. He is clinically euvolemic. What is the most likely diagnosis?

Accepted Answer

Syndrome of inappropriate antidiuretic hormone secretion

Answer

Cerebral salt wasting

Answer

Primary adrenal insufficiency

Answer

Pseudohyponatremia from hypertriglyceridemia

Answer

Renal salt loss from loop diuretic therapy

Small cell lung cancer with SIADH — RCPSC IM MCQ

A 67-year-old smoker has cough, weight loss and confusion. CT chest shows a central hilar mass with mediastinal lymphadenopathy. Sodium is 119 mmol/L, serum osmolality is low, urine osmolality is high and urine sodium is 64 mmol/L. He is clinically euvolemic. What is the most likely diagnosis?