22nd May 2025

A 63-year-old lady with a previous history of gallstones and alcoholism presents with deranged LFTs.

A 63-year-old lady with a previous history of gallstones and alcoholism presents with deranged LFTs. She is noted to have a serum sodium of 131 mmol/L. serum osmolality is 250 mOsmol/L and urinary sodium is noted to be 17 mmol/L. She is noted to have a heart rate of 130 bpm with a blood pressure of 95/70 and is given aggressive fluid resuscitation with 0.9% saline.

Which of the following is the most likely cause for her presentation? Please select only ONE answer.