#april2020mccqe1
A 71-year-old woman undergoes an elective sigmoid resection for recurrent diverticulitis. On the second postoperative day, it is noted that her urinary output is averaging only 35 to 45 mL/h. She is receiving 5% dextrose in half normal saline at a rate of 100 mL/h. The intravenous rate of infusion is increased to 125 mL/h. Two days later, her urinary output becomes 15 to 25 mL/h. A sample of urine shows a urinary sodium concentration of 85 mEq/L. Laboratory studies show the systemic arterial values as follows:
pH 7.25
pco2 30 mm Hg
Bicarbonate 15 mEq/L
Potassium 5.8 mEq/L
BUN 85 mg/dL
Creatinine 5.1 mg/dL
Which of the following is the most likely diagnosis?
(A) Acute renal failure
(B) Excessive sodium intake
(C) Fluid volume deficit
(D) Surgical ligation of both ureters
(E) Ureteroenteric fistula
A 71-year-old woman undergoes an elective sigmoid resection for recurrent diverticulitis. On the second postoperative day, it is noted that her urinary output is averaging only 35 to 45 mL/h. She is receiving 5% dextrose in half normal saline at a rate of 100 mL/h. The intravenous rate of infusion is increased to 125 mL/h. Two days later, her urinary output becomes 15 to 25 mL/h. A sample of urine shows a urinary sodium concentration of 85 mEq/L. Laboratory studies show the systemic arterial values as follows:
pH 7.25
pco2 30 mm Hg
Bicarbonate 15 mEq/L
Potassium 5.8 mEq/L
BUN 85 mg/dL
Creatinine 5.1 mg/dL
Which of the following is the most likely diagnosis?
(A) Acute renal failure
(B) Excessive sodium intake
(C) Fluid volume deficit
(D) Surgical ligation of both ureters
(E) Ureteroenteric fistula
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