PAEA Surgery End Of Rotation (EOR) Practice Exam

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What is a cause of hypervolemic hyponatremia?

Cirrhosis
Prolonged vomiting
Excessive water intake
High aldosterone levels

The correct answer is: Cirrhosis

Hypervolemic hyponatremia occurs when there is an excess of total body water relative to sodium, leading to dilution of serum sodium levels. One common cause of this condition is cirrhosis. In cirrhosis, the liver's ability to produce proteins, particularly albumin, is compromised. This reduction in albumin leads to decreased oncotic pressure, resulting in fluid accumulation in the interstitial spaces and the development of edema. Moreover, the body responds to the perceived hypovolemia (due to fluid shifts) by activating the renin-angiotensin-aldosterone system (RAAS), which further promotes sodium and water retention, exacerbating the hypervolemic state. Thus, the combination of fluid retention and dilution of serum sodium contributes to the occurrence of hypervolemic hyponatremia in patients with cirrhosis.