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Which of the following conditions is not typically indicated by increased specific gravity?

  1. Dehydration

  2. Diabetes insipidus

  3. Renal failure

  4. Shock

The correct answer is: Diabetes insipidus

Increased specific gravity of urine is typically associated with conditions that lead to more concentrated urine, which often occurs as a physiological response to dehydration or reduced kidney function. Dehydration, for example, results in less water being filtered through the kidneys, leading to a higher concentration of solutes in the urine, thus increasing its specific gravity. Similarly, renal failure can lead to a variety of concentrations in urine, but may often mean the kidneys are not excreting waste effectively, leading to variability in specific gravity, but generally can cause an increase depending on the stage and nature of the failure. Diabetes insipidus, on the other hand, is characterized by the inability of the body to concentrate urine effectively due to a deficiency of antidiuretic hormone (ADH) or the kidneys' resistance to it. As a result, patients with diabetes insipidus excrete large volumes of dilute urine, leading to a decreased specific gravity rather than an increase. This distinguishes it from the other conditions listed, which all result in more concentrated urine. Shock can also lead to a temporary increase in specific gravity due to possible dehydration or compromised kidney function. Thus, the correct answer, which indicates a condition not typically associated with increased specific gravity, accurately reflects the