Amanda Richards is a 20-year-old junior in college. She is majoring in biology a

Question

Amanda Richards is a 20-year-old junior in college. She is majoring in biology and hopes someday to be a pediatrician. Beginning about a month ago, Amanda noticed that she was waking up once, sometimes twice a night, by the need to go to the bathroom. More recently, she has noticed that she needs to go to the bathroom during her school day much more frequently than before, sometimes as often as once every hour. At first Amanda thought that her increased frequency of urination was due to the coffee she drank, but when she reduced her coffee consumption to one cup in the morming, she still needed to go to the bathroom just as often. In addition, Amanda was buying bottled water by the case, and she found herself never without a beverage in her hand or nearby. She also noticed that her urine seemed pale and colorless. When Amanda told her mother of her problem, her mother became very concerned and arranged for Amanda to see the family physician. 1. Name one possible condition that can cause polyuria (excessive urination). (2 pts) Her physician found no abnormalities on physical examination. However, a blood chemistry profile revealed Amanda's plasma sodium level to be 149 mEq/L, plasma osmolarity was 308 mOsm/L, and her fasting plasma glucose was 85 mg/dl. An analysis of Amanda's urine showed a urine osmolarity of 200 mOsm/L. The urine sample was negative for the presence of glucose. 2. What SPECIFIC condition (2 words!) is ruled out by Amanda's fasting blood glucose test and the finding that her urine tested negative for glucose? (2 pts)

Explanation / Answer

1-) Polyuria or frequent urination is having an urge of passing urine more than usual. Possible condition causing polyuria can be bladder stones and Diabetes Insipidus. Diabetes insipidus is a condition different from diabetes mellitus. Diabetes insipidus is a metabolic disorder in which there is interaction of the hormones and kidneys with defect in ADH (Antidiuretic hormone) resulting in large quantity of urine . Also the colour of urine is pale or colourless and frequent thirst is the symptom which is also shown by Amanda's symptoms. So the condition affecting her is  Diabetes Insipidus. Here urine osmolarity is typically low and there is slight high sodium level causing hypernatrimia

2-) The specific condition that has been ruled out by Amanda's fasting blood glucose test , that came out negative for glucose could be to rule out Renal glycosuria or glucosuria. Glycosuria occurs because kidneys can not stop glucose from spilling from the bloodstream into urine. In this condition there is excretion of glucose from urine when there are abnormal elevation of glucose levels in blood. So is not in case of Amanda.

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