Diabetes insipidus Quiz: Ace Your Exams
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A 42-year-old man presents to the clinic with a 1-week history of excessive thirst and urination. He reports having to wake up several times at night to drink water and urinate, which has significantly disturbed his sleep. His past medical history includes bipolar disorder and hypertension, which are managed with lithium and hydrochlorothiazide, respectively. Additionally, he underwent a transsphenoidal resection of a pituitary adenoma recently. Vital signs are within normal limits and physical examination is unremarkable. Laboratory tests are detailed below. Which of the following is the biggest risk factor in this patient for the likely underlying diagnosis?
| Laboratory study | Result |
| Serum sodium | 147 mEq/L |
| Serum osmolality | 310 mOsm/kg |
| Urine osmolality (baseline) | 250 mOsm/kg |
| Urine osmolality (after desmopressin challenge) | 400 mOsm/kg |
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