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Old 10-22-2011
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Default 10yr old with increased serum glucose and urine output

A 10 yr old boy is brought to the physician due to increased urination and progressive fatigue during the past 2 weeks. Vital signs are normal except for a pulse of 120/min. P/E shows dry mucous membranes and dry skin. His fasting serum glucose concentration is 350mg/dl. Which of the following mechanisms best explains the increased urine output in this pt?

A. Decreased synthesis and release of ADH
B. Disruption of the transverse gradient in the LOH
C. Increased GFR
D. Increased osmolarity in the tubular lumen
E. Inhibition of the sodium-glucose transporter in the PCT
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Old 10-22-2011
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Increased osmolarity.
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Old 02-24-2012
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increased osmolority due to increased glucose molecules.
after saturation of glucose carriers,the excess glucose remains in the lumen and retains water along with it(and also Na+ and K+) resulting in osmotic diuresis..
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Old 02-24-2012
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The stem tells you
-the patient has i high blood glucose
-has increased urinary frequency
-has signs of dehydration

You need to rule out type 1 DM- and he has Osmotic diuresis.....
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