The Daily PANCE PANRE Question 52

A 32 year-old male presents after slipping and falling off the roof of his home and striking his head. He suffered a brief loss of consciousness. Since that time, he has noted increasing urination and thirst. His serum chemistries reveal an elevated sodium level. His urine specific gravity is 1.003. Which of the following is the most likely diagnosis? A. cerebral contusion B. subarachnoid hemorrhage C. epidural hematoma D. diabetes insipidus E. renal contusion Answer:D, diabetes insipidus Diabetes inspidus (ADH deficiency) can occur after acute head trauma. ADH is secreted by the posterior pituitary gland and causes the body to retain fluid (to increase volume). In a patient who has damaged the posterior pituitary, ADH is not secreted, so the body urinates "water". There is frequent large volume urination with a very low specific gravity, and will cause hypernatremia unless the patient is given large quantities of water to drink Help Support The Physician Assistant Life for FREE! 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His serum chemistries reveal an elevated sodium level. His urine specific gravity is 1.003. Which of the following is the most likely diagnosis? cerebral contusion subarachnoid hemorrhage epidural hematoma diabetes insipidus renal contusion Answer:D Diabetes insipidus Diabetes insipidus (ADH deficiency) can occur after acute head trauma. ADH is secreted by the posterior pituitary gland and causes the body to retain fluid (to increase volume). In a patient who has damaged the posterior pituitary, ADH is not secreted, so the body urinates "water." There is frequent large volume urination with a very low specific gravity and will cause hypernatremia unless the patient is given large quantities of water to drink. Know Your NCCPAContent Blueprint Diabetes insipidus is covered in theNCCPA ContentBlueprint Endocrinology (6%) 6-year-old with polyuria, weight loss, and recent seizures (watch video) Learn more about diabetes insipidus, watch the ReelDX patient video case and take the lesson quiz atSmarty PANCE Diabetes Insipidus Note: * This is part of the Daily PANCE and PANRE in your inbox email series: 60 days of PANCE and PANRE Questions and Answers delivered directly to your inbox. It is a great and fun way to learn! If you haven't already, you can sign up for FREE by clicking Here. Help support The PA Life for FREE! This is provided as an opportunity for anyone who appreciates this email series to help support it painlessly. If you are going to be purchasing anything from Amazon.com (books, school supplies, etc.) simply start your next Amazon.com purchase by clicking here... it's a free way for you to help support the cause! Just click over to Amazon.com then, when you make your purchase, Amazon will send a portion of the proceeds to The Physician Assistant Life. The money goes toward paying for one-time and ongoing costs (like equipment, hosting, backup services, etc.). Thank you for supporting the site and keeping this content free! If you are studying for the PANCE or the PANRE I recommend thesereview books Just took and passed the PANCE!! I breezed through the test and scored well. Your course was a huge help in preparing. Both knowledge and test-taking skills. I would highly recommend this to others. Karen Hendricks PA-C Just completed the PANRE and passed quite comfortably. I used your practice exams as part of my preparation. They were quite helpful for question format and content. Thanks for providing such a useful service. Steve Smith, PA- S, Hospitalist at Gerald Champion Regional Medical Center This is the absolute best way to prep for the PANRE. I have worked as PA-C since 1999. Family Practice is my area of expertise. My first time I decided not to study and take the test and see how I would do. I barely missed passing the test. A little frustrating but not a big deal. Now it is time to study. I looked at a number of systems and decided to use SmartyPANCE and the PA Life Academy. I did modify it by just taking test questions over a two month period and allowing the questions to teach me. I easily passed and improved my score by over 50 points. My take away is to continue the daily questions Stephen sends out and then taking tests and researching areas I need to shore up. Thanks Stephen for a practical approach to PANRE. Gregory Bickel, PA-C Good morning. I purchased a three-month trial of SMARTYPANCE with the hopes of using it as an adjunct to other study materials that I had purchased. Almost immediately, I ditched everything else and used your website exclusively. I work full time and I have two little ones at home, so just like everyone else, it was hard for me to manage my time. My certification is ending this year and I timed it so that if I didn’t pass, I’d have another opportunity to re-take it in December if I failed. I just found out this morning that I passed my PANRE! I studied for one {stressful} month, and though I wouldn’t advise cramming everything in such a short period of time, your website really helped me so much. Thank you for putting all of this content out there for us. You are amazing! Jenssen Parungao, PA-C Im a PA student graduating in December and taking my PANCE about 4 weeks from now. Your website has become one of my favorite study tools, so thanks for all your work in putting that together! Caitlin Anderson, PA-S I PASSED! Fifth time taking the PANRE. Was totally lost on how to review. Luckily I came across your website and signed up. Did every module in both the PA Life and SmartyPANCE. 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