Nephrology Q 32

A 25-year-old woman is evaluated in the emergency department for chest pain after a belted motor vehicle accident. She is pregnant at approximately 23 weeks' gestation. She reports no additional symptoms and is otherwise well. Her only medication is a prenatal vitamin.

On physical examination, the patient is afebrile, blood pressure is 102/62 mm Hg, and pulse rate is 80/min. Pain and bruising over the left chest wall are noted. Abdominal examination findings are consistent with changes of pregnancy.

Laboratory studies are significant for a serum sodium level of 132 mEq/L (132 mmol/L).

Which of the following is the most likely cause of this patient's low serum sodium level?

A Excessive water intake

B Hypotension-induced antidiuretic hormone release

C Normal physiologic change in pregnancy

D Syndrome of inappropriate antidiuretic hormone secretion

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