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Review Question - QID 214428

Syndrome of Inappropriate ADH (SIADH) Studies Serum labs QID: 214428 (M1.OMB.1)
In scope icon M 2 A
QID 214428 (Type "214428" in App Search)
A 71-year-old man presents to the emergency department after he was found to be confused by his daughter. His past medical history is significant for episodes of depression and mania that has been well controlled on medications. He drinks 2 drinks per day and has smoked 1 pack per day for the last 40 years. On presentation, he is found to only be oriented to self and is unable to provide a coherent history. His temperature is 98.6°F (37°C), blood pressure is 131/71 mmHg, pulse is 86/min, and respirations are 16/min. Physical exam reveals a disheveled, obese man with no focal findings. Laboratory tests show the following:

Serum:
Na+: 122 mEq/L
Cl-: 95 mEq/L
K+: 3.9 mEq/L
HCO3-: 23 mEq/L
Glucose: 215 mg/dL

Urine:
WBC: 2/hpf
Nitrites: Negative
Osmolality: 512 mOsm/kg

Which of the following is most likely cause of this patient's symptoms?
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