<s>[INST] context: Hypernatretrula 


Hypematremia is defined as Na+ Concentration > 150 meq/L.
Most children with hypematremia are dehydrated and show typical clinical signs and symptoms.
Children with hypernatremic dehydration tend to have better preservation of intravascular volume because of the shift of water from the intracellular to extracellular space.
This maintain blood pressure and urine output, and allows hypernatremic infant to be less symptomatic initially and potentially to become more dehydrated before medical attention is sought.
Probably because of intracellular water loss, the pinched abdominal skin of a hypematremic dehydrated infant has a "doughy" feel.
Hyperntremia causes CNS symptoms due to neuronal shrinkage (water shifts out of the cell) : -

❑ Lethargy                ❑ Irritability                                        ❑ Restlessness ❑ Weakness             ❑ High pitched cry and hyperpnea
❑ Nausea  ❑ Fever

Hypematremia is associated with hypoglycemia and mild hypocalcemnia.
Brain hemorrhage is the most devastating consequence of hypernatremia --> may be subarachnoid, subdural or meningeal.
Seizures and coma may occur, seizures are more common during correction of hypematremia.
Although central pontine myelinosis is classically associated with rapid correction of hyponatremia, it can occur in children with hypernatremia. [/INST] question: In hypernatremic dehydration following symptom & signs are seen – a)  Irritabilityb)  Lethargyc)  Drowsinessd)  Oliguria | options: A: ac B: ab C: ad D: bc | answer: B </s>