A 55-year-old man with fever, vomiting, poor intake, dry mucous membranes, and orthostatic changes has which most likely diagnosis?

A 55-year-old man with fever, vomiting, poor intake, dry mucous membranes, and orthostatic changes has which most likely diagnosis?

• A. Hypervolemia
• B. Euhydration
• C. Volume depletion
• D. Septic shock

Answer: (C)

The main idea here is assessing a patient’s fluid status based on history and signs. Fever and vomiting cause fluid loss, and poor intake reduces further intake of fluids. Dry mucous membranes are a classic sign of reduced body fluids, and orthostatic changes indicate decreased circulating volume with impaired venous return. Taken together, these features point to volume depletion from dehydration. Hypervolemia would show fluid overload with signs like edema and moist mucous membranes or hypertension. Being euhydrated means normal fluid status with no orthostatic drops. Septic shock can accompany fever, but it centers on systemic hypoperfusion with persistent hypotension and different perfusion signs; dehydration with orthostatic intolerance better explains this presentation.

The main idea here is assessing a patient’s fluid status based on history and signs. Fever and vomiting cause fluid loss, and poor intake reduces further intake of fluids. Dry mucous membranes are a classic sign of reduced body fluids, and orthostatic changes indicate decreased circulating volume with impaired venous return. Taken together, these features point to volume depletion from dehydration.

Hypervolemia would show fluid overload with signs like edema and moist mucous membranes or hypertension. Being euhydrated means normal fluid status with no orthostatic drops. Septic shock can accompany fever, but it centers on systemic hypoperfusion with persistent hypotension and different perfusion signs; dehydration with orthostatic intolerance better explains this presentation.