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A 17 year old girl comes to the physician because of fatigue, increased thirst, and increased urination over the past 2 weeks. She has had a 4.5 kg (10 lb) weight loss during this period despite an increased appetite. She has not had dysuria. At the onset of her symptoms, she had a mild upper respiratory tract infection that resolved without treatment. Her temperature is 36.8 deg C (98.2 deg F), pulse is 86/min, respirations are 14/min, and blood pressure is 100/50 mm Hg. Cranial nerves are intact. Muscle strength is 5/5, and deep tendon reflexes are symmetric. Serum studies show: Na+ is 132, Cl- is 96, K+ is 3.7, HCO3- is 26, and Creatinine is 1.2. Which of the following is the most likely location of the primary disease process?
A) Adrenal gland
B) Bone marrow
C) CNS
D) Kidney
E) Liver
F) Muscle
G) Pancreas
H) Parathyroid gland
I) Pituitary gland
J) Thyroid gland
I won't say the answer now, but someone told me that its a case of spurious hyponatremia. Can anyone explain why is it so?
A) Adrenal gland
B) Bone marrow
C) CNS
D) Kidney
E) Liver
F) Muscle
G) Pancreas
H) Parathyroid gland
I) Pituitary gland
J) Thyroid gland
I won't say the answer now, but someone told me that its a case of spurious hyponatremia. Can anyone explain why is it so?