Perioperative care: postoperative hyponatraemia: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Perioperative care: postoperative hyponatraemia

Sample item

Two days after lobectomy for lung cancer, a patient is confused with serum sodium 122 mmol/L, low plasma osmolality, high urine osmolality and normal volume status. What is the first-line management?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Fluid restriction

Euvolaemic hyponatraemia with concentrated urine fits SIADH, which follows lung surgery, pain and drugs. Fluid restriction is first line, with slow correction of sodium to avoid osmotic demyelination.

Option by option

  • A. Fluid restriction (correct)

    Correct. Fluid restriction treats SIADH.

  • B. Rapid large-volume normal saline

    Large volumes of saline worsen the dilution when ADH is high.

  • C. Desmopressin

    Desmopressin would aggravate water retention.

  • D. Rapid 3 percent saline to normal sodium

    Rapid correction risks osmotic demyelination.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is A, Fluid restriction. Euvolaemic hyponatraemia with concentrated urine fits SIADH, which follows lung surgery, pain and drugs.

Why is "Rapid large-volume normal saline" not the answer?

Large volumes of saline worsen the dilution when ADH is high.

Why is "Desmopressin" not the answer?

Desmopressin would aggravate water retention.

Why is "Rapid 3 percent saline to normal sodium" not the answer?

Rapid correction risks osmotic demyelination.

What concept does this question test?

It tests Perioperative care: postoperative hyponatraemia in General Surgery. Fluid restriction is first line, with slow correction of sodium to avoid osmotic demyelination.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Perioperative care: postoperative hyponatraemia?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.