An 8-Year-Old Boy Is Brought to the Office Due to a 2-Month

question 362

Multiple Choice

An 8-year-old boy is brought to the office due to a 2-month history of excessive urination.  The parents report that the boy is sometimes irritable and restless and has been drinking excessive amounts of water.  He has had normal growth with achievement of all expected milestones and takes no medications.  The patient's maternal grandfather tends to drink excess amounts of water.  Vital signs reveal tachycardia.  On physical examination, mucous membranes are dry.  Neurologic examination shows no focal deficits.  Laboratory results on a random blood sample are as follows: Urine osmolality is 120 mOsm/kg H₂O.  Which of the following is the most appropriate next step in management?

• A)Chest x-ray
• B)Fractional excretion of sodium
• C)MRI of the brain
• D)Oral glucose tolerance test
• E)Renal ultrasound
• F)Water deprivation test

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Operation Smile

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