At a first aid station on a marathon route, a patient after the race complains of headache, muscle cramps, weakness, nausea, and confusion. Which statement made by the patient might explain these symptoms?
a. "I was really thirsty after the race. I drank several large bottles of water."
b. "I perspired quite a bit during the race so I drank sports drinks when I finished."
c. "I take steroids regularly and did not stop taking them for the race."
d. "I am diabetic and checked my blood sugar after the race. It was normal."
A
Excess intake of hypotonic solutions (e.g., several large bottles of water) will result in hyponatremia, the symptoms described by this patient. Sports drinks contain electrolytes lost through perspiration, so this would not explain the patient's symptoms, indicating hyponatremia. Steroid administration can result in hypokalemia, but the patient's symptoms do not match the symptoms of hypokalemia, so this is not a good explanation. The statement about diabetes does not provide information relevant to the patient's symptoms or to the situation.
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