🏥 USMLE Exam Prep

A 65-year-old male is admitted with severe confusion and a serum sodium of 108 mEq/L. He has a history of SIADH. Over the first 2 hours, his sodium rises to 118 mEq/L after receiving 3% hypertonic saline. What is the most significant potential complication of this rapid correction?

A Cerebral edema
B Central pontine myelinolysis
C Seizures
D Worsening SIADH

✓ Correct Answer: Option B

Rapid correction of chronic severe hyponatremia (>8-12 mEq/L in 24 hours, or >10 mEq/L in first 24 hours, or >18 mEq/L in 48 hours) risks osmotic demyelination syndrome, particularly central pontine myelinolysis, due to rapid osmotic shifts.

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