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26 Cards in this Set
- Front
- Back
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action that ADH has on the kidney
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increases the permeability of the collecting duct
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normal serum osmolality
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285 mosmol/kg
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the primary manifestation of a disorder of the posterior lobe of the pituitary
what is the most common source of the proble |
diabetes insipidus
nearly all cases are due to hypothalamic disease |
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urine excretion rate in diabetes insipidus
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24 hour urine greater than 50 cc/kg
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the absence of nocturia in patients w/ suspected DI suggests ___ instead
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psychogenic polydipsia
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most common cause of hypothalamic DI
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idiopathic
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three categories of diabetes insipidus
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pituitary (central, cranial)
nephrogenic primary polydipsia |
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two drugs that can cause an acquired nephrogenic DI
AVP antagonists |
lithium and demeclocycline
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inappropriate excessive fluid intake w/ functional suppression of AVP secretion
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primary polydipsia
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indications for a water deprivation test
what is the purpose of the test? |
suspected DI (polydipsia, polyuria), w/ serum osmolality between 280 and 295
confirmation of diagnosis of DI, exclusion of primary polydipsia |
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deficiency of what may mask diabetes insipidus?
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cortisol
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most common cause of primary polydipsia
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psychogenic (OCD,schizo, psycho)
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the absence of response to water deprivation is diagnostic of ___
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diabetes insipidus
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plasma osmolality is greater than 290-295, suggests ___
how to distinguish between the two? |
central DI or nephrogenic DI
response to exogenous AVP |
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pt w/ polydipsia/polyuria responds to fluid deprivation test. dx?
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primary polydipsia
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treatment for mild central diabetes insipidus
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ensure free access to water and watch them
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treatment for moderate/severe central diabetes insipidus
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DDAVP
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drugs that occasionally work in treatment of nephrogenic DI
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thiazides, prostaglandin inhibitors, amiloride
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treatment for primary polydipsia
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counseling and fluid restriction
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three buzz words for SIADH
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cancer
lungs CNS |
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oncology drugs can frequently cause ___
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SIADH due to lowered Na concentration
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two ectopic producers of ADH in the body
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malignancies
pulmonary disorders |
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the clinical features due to SIADH are dependent upon ___
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the degree and rapidity of development of hyponatremia
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how to distinguish SIADH from subclinical hypovolemia
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urine Na+ is less than 20 in hypovolemics, and greater in SIADH
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treatment for SIADH
if acute neurologic sequela are present? |
restrict fluids, monitor serum Na+, demeclocycline (AVP antagonist)
hyertonic saline IV |
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too rapid correction of hyponatremia may lead to ___
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central pontine myelinolysis
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