A 65 year old white male has a 40 pack year history of cigarette smoking


Question Number 0947
Question:
A 65 year old white male has a 40 pack year history of cigarette smoking. He is found to have a spot on his chest X-ray. A biopsy confirms that he has small cell carcinoma of the lung and he is admitted to the hospital. Over the course of the next few days he develops lethargy and confusion and then proceeds to have a seizure. His urine output remains normal. Laboratory tests are performed on his blood and his urine. The specific gravity of his urine is elevated. His urine tests negative for glucose and negative for ketones. His blood glucose is elevated and his serum osmolality is low; specifically, he has hyponatremia. Water restriction is begun, and his symptoms improve. What is the most likely diagnosis?
a) diabetes mellitus
b) diabetes insipidus
c) psychogenic polydipsia
d) syndrome of inappropriate ADH secretion
e) acute renal failure


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