8 board-style questions on hyponatremia in the PulseMD family medicine question bank — physician-reviewed, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.
A 34-year-old man presents to the emergency department with severe fatigue, dizziness, nausea, and vague abdominal pain that has worsened over 2 weeks. He has a history of vitiligo. On examination, his blood pressure is 82/54 mmHg and heart rate is 112 bpm. Hyperpigmentation is noted on the palmar creases, gingiva, and recent surgical scars. Laboratory results show sodium 128 mEq/L, potassium 6.1 mEq/L, and glucose 62 mg/dL. What is the most likely diagnosis?
A 55-year-old woman with known small cell lung cancer is found to have a sodium of 121 mEq/L; it was 124 mEq/L on routine labs 3 weeks ago. She reports mild fatigue but has no confusion, headache, nausea, or focal neurological deficits and is hemodynamically stable. Serum osmolality is 252 mOsm/kg, urine osmolality 450 mOsm/kg, urine sodium 55 mEq/L. She is euvolemic. TSH and morning cortisol are normal. She is started on fluid restriction to 800 mL/day. After 48 hours, repeat sodium is 123 mEq/L. What is the most appropriate next step in management?
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