This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
[{'content': 'In hypernatremic dehydration following symptom & signs are seen – a)  Irritabilityb)  Lethargyc)  Drowsinessd)  Oliguria \nSelect and explain. \nA. ac, B. ab, C. ad, D. bc', 'role': 'user'}, {'content': 'Answer: B \nExplanation: Hypernatretrula \n\n\nHypematremia is defined as Na+ Concentration > 150 meq/L.\nMost children with hypematremia are dehydrated and show typical clinical signs and symptoms.\nChildren with hypernatremic dehydration tend to have better preservation of intravascular volume because of the shift of water from the intracellular to extracellular space.\nThis 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.\nProbably because of intracellular water loss, the pinched abdominal skin of a hypematremic dehydrated infant has a "doughy" feel.\nHyperntremia causes CNS symptoms due to neuronal shrinkage (water shifts out of the cell) : -\n\n❑ Lethargy\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0 ❑ Irritability\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0 ❑ Restlessness ❑ Weakness\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0\xa0 ❑ High pitched cry and hyperpnea\n❑ Nausea\xa0 ❑ Fever\n\nHypematremia is associated with hypoglycemia and mild hypocalcemnia.\nBrain hemorrhage is the most devastating consequence of hypernatremia --> may be subarachnoid, subdural or meningeal.\nSeizures and coma may occur, seizures are more common during correction of hypematremia.\nAlthough central pontine myelinosis is classically associated with rapid correction of hyponatremia, it can occur in children with hypernatremia.', 'role': 'assistant'}]