A cancer patient's susceptibility to the syndrome of inappropriate antidiuretic hormone (SIADH) can be suspected with which of the following laboratory results?
a. Serum potassium of 5.2 mmol/L
b. Serum sodium of 120 mmol/L
c. Hematocrit of 40%
d. Blood urea nitrogen (BUN) of 10 mg/dL
ANS: B
In SIADH, there is increased secretion of antidiuretic hormone (ADH) from the posterior pituitary gland, leading to increased water reabsorption from the distal convoluted tubule and collecting duct. As a result, weight increases and serum sodium and hematocrit levels are diluted, and, hence, a low serum sodium level is seen. ADH has no direct effect on serum potassium, because potassium is primarily an intracellular electrolyte and changes in the serum concentration of potassium rarely occur in SIADH. The blood urea nitrogen is normal.
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