Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
12 Cards in this Set
- Front
- Back
|
Causes of central diabetes insipidus.
|
- idiopathic
- familial - Neurosurgical or posttraumatic (hypothalamus or pitutiary - Cancer - Hypoxic encephalopathy - Infiltrative disorders (histiocytosis X or sarcodosis) - Post SVT - Anorexia nervosa |
|
|
Causes of nephrogenic diabetes insipidus.
|
- Hereditary (x-linked due to V2 receptor defect)
- Lithium toxicity - Hypercalcemia (luminal effect on ion and water channels) - Hypokalemia - Sickle cell disease, amyloidosis, Sjogrens, cidofovir, foscarnet - Gestational DI (due to placental vasopressinase) |
|
|
What clinical test can be used to differentiate central from nephrogenic diabetes insipidus?
|
Water deprivation test
- if plasma osmolarity raises above 300 then it's central - if less than 300, it's nephrogenic |
|
|
What are some factors that stimulates ADH release?
|
- hyperosmolarity
- hypovolumia - stress - nausea - pregnancy - hypoglycemia - nicotine, morphine |
|
|
What are some factors that inhibit ADH release?
|
- hypo-osmolarity
- hypervolemia - ethanol - phenytoin |
|
|
How to treat central diabetes insipidus?
|
- Desmopressin (oral and intranasal) : treat symptomatically
- Chlopropamide (improves response to ADH) - Carbamazepine or clofibrate - Thiazides (by causing volume depletion) and NSAIDs (by antagonizing prostaglandin |
|
|
How to treat nephrogenic diabetes insipidus?
|
- Thiazides and NSAIDs
- Amiloride can block lithium nephrotoxicity - Decreased solute (salt and protein) intake - Supraphysiologic doses of dDAVP |
|
|
How to treat nephrogenic diabetes insipidus caused by lithium?
|
- Amiloride
|
|
|
Which electrolyte imbalance can cause all these symptoms?
- Muscle weakness - Intestinal ileus (anorexia, abd distention,constipation) - Cardiac arrhythmias - Rhabdomyolysis - Renal dysfunction - Glucose intolerance |
hypokalemia
|
|
|
Actions of aldolsterone.
|
- Opens sodium and potassium channels in the luminal membrane of cortical collecting tubule
- Activates Na-K-ATPase in basolateral membrane - Permissive effect increasing H secretion due to luminal negativity - Increases K loss in colonic and salivary secretions and sweat |
|
|
Why isn't there edema in hyperaldolsteronism?
|
- Atrial natriuretic peptide
- Pressure natriuresis due to increased renal perfusion pressure |
|
|
Treatment for hyperaldolsteronism.
|
- spironolactone
- amiloride + HCTZ |
