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A 32-year-old previously healthy male software engineer presents urgently to his primary care physician reporting extreme, unquenchable thirst and massive urine output for the past 5 days. He describes drinking 10-15 liters of water per day. Urinating large volumes (estimated 8-12 liters/day) of clear, watery urine, waking him up 5-6 times nightly for restroom. Constant feeling of dry mouth feeling fatigued and slightly lightheaded. No recent illness, head trauma, or surgery. BP 125/80 mmHg (lying), 115/75 mmHg (standing). Pulse 88 bpm Urine appears clear with low specific gravity. Urine osmolarity is 75 mOsm/kg Serum Sodium Na+158 mmol/L, Serum Osmolality: 310 mOsm/kg) ,. Plasma Glucose: normal ADH challenge test shows dramatically decrease in urine output within 1-2 hours. Urine Osmolality rises sharply from 75 mOsm/kg to 650 mOsm/kg. Serum osmolarity and Na+ start to trend down. What is the most appropriate medical treatment of his condition?

Renal compensations of metabolic acidosis are ________________ (SELECT 2 ANSWERS)

What is the most probable enzyme deficiency disorder in following two sisters with an untreated medical condition?

The following patient is diagnosed and treated for right breast cancer. What is the cause of her right limb  swelling?    

In the following diagram, letter ___________ indicates tidal volume.   

A 75-year-old male is found lethargic at home with a blood pressure of 100/60 and temperature of 98F.Labs: Na=138 mEq/L, K= 2.8 mEq/L, HCO3=9 mEq/L, Cl=118 mEq/L, Creatinine= 1.0 mg/dL, BUN=20 mg/dL, Ca= 10 mg/dL, PO2=80, PCO2= 25 and pH= 7.29. Urine pH=4.5  What is the most likely cause of the patient’s disorders?  

A 28-year-old man who is receiving lithium treatment for bipolar disorder becomes polyuric. His urine osmolarity is 90 mOsm/L; it remain at same level after he is given a nasal spray of ADH (dDAVP). What is the diagnosis?                              

All of the followings are signs of hypovolemia (dehydration) EXCEPT

A 55-year-old woman presents to the clinic complaining of fatigue and weight gain for the past 2 months. She endorses cold intolerance, constipation, and dry skin but denies fever, diarrhea, swelling, chest pain, or shortness of breath. A physical examination demonstrates a lethargic, stocky patient with brittle hair. Her past medical history is significant for asthma that is well controlled with her rescue inhaler. What set of lab values confirms diagnosis of her medical condition?

A 35-year-old woman admitted to the labor and delivery suite at 4 am. Her amniotic membranes ruptured approximately 6 hours earlier, but her contractions have decreased from one every 3 min to one every 5 to 7 minutes. She is primipara. On physical examination, she has a blood pressure of 140/85 mmHg, pulse of 100 bmp and a sinus tachycardia rhythm. Her temperature is 98.6° F. Labs shows serum glucose 135 mg/dL, BUN 10 mg/dL, creatinine 0.4 mg/dL, Crit 38% , HbA1c of 6. The fetal heart rate is 120 bpm. The cervix is dilated to 3 cm. According to her previous records, she is at 41 weeks’ gestation, and she has gestational diabetes. If the physician wants to increase the rate and strength of uterine contraction, which of the following would be given to the woman?