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Depression in a care home resident — SCE Geriatric Medicine MCQ

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HardOld age psychiatryDepression in a care home residentSCE Geriatric Medicine

An 81-year-old records 800 mL urine while awake and 1,200 mL during the sleep period, including the first morning void. Total 24-hour urine is 2,000 mL and voided volumes are otherwise normal. What does the diary demonstrate?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: C — Nocturnal polyuria, because the nocturnal fraction is 60%

Explanation lettering: E = shown as D · D = shown as E

C is correct: nocturnal urine is 1,200/2,000 = 60% of 24-hour output, well above the approximately one-third threshold used in older adults. Total volume is not globally polyuric. Normal voided volumes argue against reduced functional capacity, and the diary contains no retention evidence for overflow. The distinction matters because nocturnal polyuria prompts review of oedema redistribution, heart failure, sleep apnoea, evening intake and diuretic timing rather than empiric overactive-bladder treatment.

Reference: NHS Devon Formulary: Nocturia: https://northeast.devonformularyguidance.nhs.uk/referral-guidance/eastern-locality/urology/nocturia