A 54-year-old patient with pulmonary tuberculosis is evaluated for syndrome of inappropriate ADH secretion (SIADH). Which of the following electrolyte imbalances would be expected in this patient?

Choice A reason: Abnormally dilated arteries and veins, also known as aneurysms and varicose veins respectively, can occur due to various conditions. However, they are not the primary cause of stable angina and atherosclerosis. Aneurysms involve an abnormal widening or ballooning of a portion of an artery due to weakness in the wall of the blood vessel, while varicose veins refer to enlarged, twisted veins commonly found in the legs. These conditions do not directly cause the chronic narrowing of arteries that characterize atherosclerosis and lead to stable angina.

Choice B reason: Deep vein thrombosis (DVT) is a condition where a blood clot forms in a deep vein, usually in the legs. Although DVT is a serious medical condition that can lead to complications such as pulmonary embolism if the clot travels to the lungs, it is not related to the pathophysiology of atherosclerosis or stable angina. DVT involves venous circulation, whereas atherosclerosis and angina involve the arterial system, specifically the coronary arteries.

Choice C reason: Abnormal thickening and hardening of blood vessel walls, also known as atherosclerosis, is the primary cause of stable angina. Atherosclerosis is characterized by the buildup of plaque within the arterial walls, leading to their hardening and narrowing. This process reduces blood flow to the heart muscle, causing ischemia, which presents as chest pain, known as angina. Stable angina is a symptom of this chronic condition, which can lead to more severe cardiovascular events if left untreated.

Choice D reason: Autonomic nervous system dysfunction involves abnormalities in the autonomic nervous system, which controls involuntary bodily functions such as heart rate, blood pressure, and digestion. While autonomic dysfunction can contribute to various cardiovascular issues and symptoms such as irregular heartbeats or blood pressure changes, it is not the underlying cause of atherosclerosis or stable angina. Atherosclerosis is primarily a disease of the arterial walls, while autonomic dysfunction pertains to the regulation of bodily systems.

Choice A reason: Autonomic dysreflexia is a condition that occurs in individuals with spinal cord injuries, typically at or above the T6 level. It is characterized by a sudden and severe increase in blood pressure (hypertension), accompanied by a slowed heart rate (bradycardia) and severe headache. This condition results from an exaggerated autonomic response to stimuli below the level of the spinal cord injury, such as a distended bladder or bowel, leading to the release of catecholamines and subsequent vasoconstriction.

Choice B reason: Hypotension and shock are not characteristic of autonomic dysreflexia. Instead, autonomic dysreflexia involves hypertension. Hypotension and shock are more commonly associated with conditions such as spinal shock or severe blood loss, not the autonomic crisis seen in autonomic dysreflexia.

Choice C reason: Extreme pain below the level of injury can occur in individuals with spinal cord injuries, but it is not a hallmark of autonomic dysreflexia. The condition is primarily marked by the triad of hypertension, bradycardia, and headache. Pain below the level of injury may be related to other complications of spinal cord injury but does not define autonomic dysreflexia.

Choice D reason: Pallor and vasodilation above the level of injury are not typical features of autonomic dysreflexia. In fact, above the level of injury, individuals may experience vasoconstriction and flushing due to the altered autonomic responses. The key symptoms of autonomic dysreflexia are hypertension, bradycardia, and headache.