Which of the following distension media used in hysteroscopy causes fluid overload and electrolyte disturbances
**Core Concept**
Distension media are used in hysteroscopy to inflate the uterine cavity and provide a clear visual field for the surgeon. However, some distension media can cause fluid overload and electrolyte disturbances, which can be life-threatening if not managed properly.
**Why the Correct Answer is Right**
Glycine (D) is a non-electrolytic distension medium commonly used in hysteroscopy. However, it can cause fluid overload and electrolyte disturbances, particularly hyponatremia, due to its high water content and lack of electrolytes. This is because glycine is not metabolized by the body and can lead to a significant increase in intravascular volume, causing dilutional hyponatremia.
**Why Each Wrong Option is Incorrect**
**Option A:** None of the above is incorrect, but we'll discuss each option separately for clarity.
**Option B:** Normal saline is an electrolytic distension medium that is commonly used in hysteroscopy. It is less likely to cause fluid overload and electrolyte disturbances compared to glycine.
**Option C:** Dextran is a colloid distension medium that is used in some types of hysteroscopy. While it can cause fluid overload, it is less likely to cause electrolyte disturbances compared to glycine.
**Clinical Pearl / High-Yield Fact**
It's essential to carefully monitor patients undergoing hysteroscopy with glycine distension medium for signs of fluid overload and electrolyte disturbances, such as hyponatremia, hypotension, and tachycardia. Immediate recognition and management of these complications can prevent serious morbidity and mortality.
**Correct Answer: D. Glycine**