Medical History: A 22-year old, 40-kg female has myasthenia gravis. During the past 6 months, she became listless, weak, developed a poor appetite leading to a weight loss of 3-kg. On physical examination in the Emergency Room, her blood pressure was 60/40 mm Hg, pulse rate was 126/min, the jugular venous column height was below the sternal angle and there was no edema.
Laboratory findings: Plasma Urine Na mM 113 136 K mM 5.7 18 Cl mM 83 130 HCO 3 mM 19 0 pH 7.34 5.2 BUN (Urea) mg/dl (mM) 94 (34) - Creatinine mg/dl (µM) 5.3 (460) - Osmolarity mOsm/kg H2O 265 438 With regard to the increment in her P Na concentration in first 24-hours, which one of the following choices would be safest? 0 mM 4 mM 8 mM 12 mM Which one of the following initial therapies would be most effective in preventing a CNS complication? Hypertonic saline alone Normal Saline alone Half-isotonic saline…
