A 57 year old man has a 30 year old history of manic depressive episodes


Question Number 0946
Question:
A 57 year old man has a 30 year old history of manic depressive episodes. He has been successfully treated with lithium. He begins drinking massive amounts of water. On some days, he drinks over 10 liters of water. His urine output is also very high. He sees his doctor and several tests are performed. His urine specific gravity is very low. His urine is negative for glucose and negative for ketones. His blood glucose is 100 and his serum osmolality is 295 mosm/kg (Normal Range - 285 - 290 mOsm/kg) His serum level of ADH is found to be normal. What is the most likely diagnosis?
a) diabetes mellitus
b) diabetes insipidus
c) psychogenic polydipsia
d) syndrome of inappropriate ADH secretion
e) oliguria

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