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A 30-year-old woman is evaluated in the Endocrinology Clinic because of increased urine output. She weighs 60 kg and has a 24 h urine output of 3500 ml. Her basal urine osmolality is 210 mOsmol/kg. She undergoes a fluid deprivation test and her urine osmolality after fluid deprivation (loss of weight 3 kg) is 510 mOsmol/kg. A subsequent injection of subcutaneous DDAVP (desmopressin acetate) did not result in any further significant rise of urine osmolality after 2 h (520 mOsmol/kg).
Which of the following is the likely diagnosis?
A. Normal
B. Primary polydipsia
C. Syndrome of inappropriate ADH
D. Pituitary DI
E. Nephrogenic DI
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