Mr. Gutteman, a 70-year-old male was brought into the ER in a comatose state. He

Question

Mr. Gutteman, a 70-year-old male was brought into the ER in a comatose state. He had suffered severe head trauma (his scalp was badly lacerated and he has an impacted skull fracture. His fracture was repaired. On the 2^nd day of his hospitalization, the aide reports that Mr. Guttemann: Is breathing irregularly, his skin is dry and flaccid, and that She has emptied his urine reservoir several times during the day. Mr.Gutteman's blood and urine tests are negative for glucose and ketones. He is found to be losing huge amounts of water in urine and the colume lost is being routinely replaced (via IV line) What is Mr. Gutteman's hormonal problem? Where the lesion is located? What do you thing caused it? Is it life threatening? Why Mr. Gutteman's water balance would be challenging if the lesion is located in hypothalamus?

Explanation / Answer

1. He is suffering from diabetes insipidus (insufficient quantity of ADH production).

Symptoms are the production of a large amount of urine and no glucose in the urine.

2. Damage leads to hypothalamus or pituitary gland

3. Here, may be the damage to the hypothalamus or pituitary glands which are responsible for the production of ADH.

4 and 5. This disease is not life threatening.But here the person cannot control dehydration by its own and many people have the normal thirst mechanism.

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