Sodium disorders

An 18-month-old girl weighing 10.0 kg has had four days of diarrhoea and has been given water and diluted cordial at home. She is lethargic with a doughy feel t…

Pre-internship · niche

A 4-year-old girl is admitted with four days of diarrhoea. She is 10 per cent dehydrated but not shocked, and her serum sodium on arrival is 172 mmol/L (135-145…

Pre-internship · middle twist

A 77-year-old woman is brought to the emergency department by her daughter because she has become confused and unsteady over three days. Five weeks ago her gene…

Clinical rotations · middle twist

A 34-year-old man is seen in the medical tent 20 minutes after finishing a marathon run on a cool, overcast morning. He drank water at every drink station. He h…

Foundations · common

A 54-year-old woman is treated for symptomatic hyponatraemia that has probably been present for several days. Her initial serum sodium concentration was 108 mmo…

Clinical rotations · niche

A 62-year-old woman who takes sertraline for depression is brought to the emergency department after a witnessed generalised tonic-clonic seizure at home. She i…

Clinical rotations · common

A 46-year-old woman presents with a generalised tonic-clonic seizure. Serum sodium is 112 mmol/L, serum osmolality is 240 mOsm/kg and glucose is 5.2 mmol/L. She…

Clinical rotations · common

A 35-year-old man reports drinking approximately 6 L of water daily because of anxiety about dehydration. He is alert, euvolaemic and not taking diuretics or an…

Clinical rotations · common

A 72-year-old man with Alzheimer’s disease is brought to the emergency room by his daughter due to confusion and lethargy over the past few days. His daughter s…

Pre-internship · middle twist