Laboratory Test: The patient was then subjected to a 2-hour water deprivation test followed by another...

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Laboratory Test: The patient was then subjectedto a 2-hour water deprivation test followed by another bloodchemistry profile and urinalysis. Of note, serum osmolalityincreased to 329mOsm/kg while serum ADH, urine specific gravity andurine osmolality remained unchanged.
Questions to Consider:
Why did the patientâ€™s serum osmolality increase?
Follow-up and Diagnosis: The patient was theninjected with a drug called DDAVP (desmopressin) which mimics theactions of ADH. One hour after the injection, serum osmolalitydecreased to 292mOsm/kg and urine osmolality increased to480mOsm/kg. Based on the patientâ€™s medical history, the resultsfrom lab tests and the, you make the differential diagnosis ofidiopathic central diabetes insipidus.
Questions to Consider:
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Why do you suspect serum osmolality decreased? Why do yoususpect urine osmolality increased? Based on these results, what ishappening to water?
What do these results suggest is the underlying cause ofdiabetes insipidus?
How does the diuresis experienced in diabetes insipidus differmechanistically from that experienced by a patient with diabetesmellitus?

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The patients serum osmolality increased because This patient is suffering from diabetes insipidus In this condition there is a deficiency of the hormone antidiuretic hormone ADH or kidneys are not responsive to ADH ADH is a hormone that acts on the collecting ducts in the nephron This hormone is released when the body is waterdeprived Waterdeprivation increases blood osmolarity Increases in the blood osmolarity stimulate the release of ADH from the posterior pituitary See Answer

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