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11161 Medicine

A patient following head injury was admitted in intensive care ward with signs of raised intracranial pressure. He was put on a ventilator and started on intravenous fluids and diuretics. Twenty-four hours later his urine output was 3.5 litres, serum sodium 156 mEq/I and serum osmolarity of 316 mOsm/kg. The most likely diagnosis based on these parameters is –

AHigh output due to diuretics
BDiabetes insipidus
CToo much infusion of normal saline
DCerebral salt retaining syndrome
Medicine
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11164 Medicine

A 45-year-old woman presents with the complaint that her toenails are thick and yellow. She is otherwise healthy and takes no medications. On examination, two toenails on the right foot and the great toenail on her left foot are affected. There is no periungual erythema, and her peripheral pulses are good. What is the best advice for this patient?

AThis nail disease will spontaneously remit.
BCBC, comprehensive metabolic profile, chest x-ray, and abdominal CT scan should be ordered to look for underlying malignancy.
COral therapies will need to be used for months until the nails have grown out.
DSampling the nail is unnecessary for definitive diagnosis.
Medicine
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