Critical care: organ donor diabetes insipidus: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

Anaesthesia · Critical care: organ donor diabetes insipidus

Sample item

A brain-dead organ donor develops polyuria of 400 mL/hour with a serum sodium of 158 mmol/L. What is the treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Desmopressin with fluid replacement

Loss of posterior pituitary function causes central diabetes insipidus in many brain-dead donors, with dilute polyuria and hypernatraemia. Desmopressin or vasopressin and replacement of volume deficits with hypotonic fluid correct it. Diuretics and hypertonic saline worsen the problem.

Option by option

  • A. Desmopressin with fluid replacement (correct)

    Correct. Desmopressin treats central diabetes insipidus.

  • B. Restriction of all fluids

    Fluid restriction leads to severe hypovolaemia and hypernatraemia.

  • C. Furosemide

    A diuretic worsens volume loss.

  • D. Hypertonic saline

    Hypertonic saline would worsen hypernatraemia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More Anaesthesia questions

Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is A, Desmopressin with fluid replacement. Loss of posterior pituitary function causes central diabetes insipidus in many brain-dead donors, with dilute polyuria and hypernatraemia.

Why is "Restriction of all fluids" not the answer?

Fluid restriction leads to severe hypovolaemia and hypernatraemia.

Why is "Furosemide" not the answer?

A diuretic worsens volume loss.

Why is "Hypertonic saline" not the answer?

Hypertonic saline would worsen hypernatraemia.

What concept does this question test?

It tests Critical care: organ donor diabetes insipidus in Anaesthesia. Desmopressin or vasopressin and replacement of volume deficits with hypotonic fluid correct it. Diuretics and hypertonic saline worsen the problem.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Critical care: organ donor diabetes insipidus?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.