Treatment of choice for TURP syndrome
**Core Concept**
TURP syndrome is a life-threatening condition that occurs after a transurethral resection of the prostate (TURP) procedure, characterized by the absorption of large amounts of irrigation fluid, leading to hyponatremia, fluid overload, and potentially severe neurological symptoms. The treatment of TURP syndrome requires rapid correction of electrolyte imbalances and fluid overload.
**Why the Correct Answer is Right**
The treatment of choice for TURP syndrome involves administering hypertonic saline to correct the severe hyponatremia, as well as diuretics to manage fluid overload. This approach helps to rapidly increase serum sodium levels and reduce fluid volume, thereby minimizing the risk of cerebral edema and other complications. The administration of hypertonic saline should be done cautiously, as rapid correction of sodium levels can lead to central pontine myelinolysis.
**Why Each Wrong Option is Incorrect**
**Option A:** Hemodialysis is not the initial treatment of choice for TURP syndrome, although it may be considered in severe cases of fluid overload or electrolyte imbalances that are refractory to medical therapy.
**Option B:** Mannitol is an osmotic diuretic that may be used to manage cerebral edema, but it is not the primary treatment for TURP syndrome.
**Option C:** Furosemide is a loop diuretic that can be used to manage fluid overload, but it is not the initial treatment of choice for TURP syndrome.
**Clinical Pearl / High-Yield Fact**
In the treatment of TURP syndrome, it is essential to monitor serum sodium levels closely and avoid rapid correction of hyponatremia to prevent central pontine myelinolysis.
**Correct Answer: A. Hemodialysis is not the correct initial treatment.**