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Old 08-16-2011
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Question CNS symptoms while treating hyponatremia!

A 41-year-old man is admitted to the hospital for progressive obtundation. On admission the patientís serum sodium level is 114 mEq/L. Treatment is initiated, and 7 hours later the patientís serum sodium level is 134 mEq/L. Over the next 4 days the patientís condition worsens with the development of dysarthria, dysphagia, and paraparesis. What pathologic process is most likely responsible for this patientís new symptoms?
(A) Cerebral edema
(B) Diffuse axonal injury
(C) Intracerebral hemorrhage
(D) Osmotic demyelination
(E) Uncal herniation
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Old 08-16-2011
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It is pontine myelosis, do not know wich group it belongs, maybe D) osmotic demyelination
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Old 08-16-2011
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its D sureeee its CPM central pontine mylenosis due to rapid i.v correction of hyponatrenemia theres is demyelination of basis pontis ..
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Old 08-16-2011
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rapid correction of hyponatremia leads to central pontine myelinosis as the stem states
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Old 08-16-2011
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right answer is D
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Old 08-17-2011
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CPM is due to demyelination secondary to increased osmolarity associated with rapid correction of hyponatremia
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