Differential Diagnosis
- Single most likely diagnosis
- E) Hyponatremia: The patient's symptoms of nausea, vomiting, weakness, headache, and mild disorientation, combined with the history of drinking large amounts of water before and during practice in high temperatures, suggest water intoxication leading to hyponatremia. The edema of the hands and feet further supports this diagnosis, as it can be a sign of fluid overload.
- Other Likely diagnoses
- B) Heat exhaustion: Given the high temperature and the patient's physical exertion, heat exhaustion is a plausible diagnosis. However, the absence of elevated body temperature and the presence of edema make hyponatremia more likely.
- D) Hypoglycemia: The patient skipped lunch, which could lead to hypoglycemia, especially after intense physical activity. However, the symptoms do not fully align with typical hypoglycemic presentations, such as confusion, tremors, or palpitations.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- C) Heat stroke: Although less likely due to the patient's normal body temperature, heat stroke is a medical emergency that can be fatal if not promptly recognized and treated. It should always be considered in cases of exertion in high temperatures.
- Rare diagnoses
- A) Dehydration: Given the patient's reported high water intake, dehydration seems unlikely. However, it could be considered if the patient had an underlying condition affecting fluid balance or if there were other signs of dehydration not mentioned in the scenario.