Podcast
Questions and Answers
Which of the following is NOT a cause of diabetes insipidus?
Which of the following is NOT a cause of diabetes insipidus?
- Ineffective ADH secretion by the posterior pituitary
- Insufficient ADH production by the hypothalamus
- Inadequate kidney response to ADH
- Increased production of ADH (correct)
What are the clinical manifestations of diabetes insipidus?
What are the clinical manifestations of diabetes insipidus?
- Polyuria, hyperglycemia, and weight loss
- Polyuria, weight gain, and increased blood pressure
- Polyuria, hypoglycemia, and excessive thirst
- Polyuria, hyperosmolality, and polydipsia (correct)
What is the underlying mechanism of nephrogenic diabetes insipidus?
What is the underlying mechanism of nephrogenic diabetes insipidus?
- The kidneys are unable to respond to ADH effectively (correct)
- The posterior pituitary gland cannot release ADH
- The kidneys are unable to produce ADH
- The hypothalamus does not produce enough ADH
What is the primary consequence of untreated diabetes insipidus?
What is the primary consequence of untreated diabetes insipidus?
In the context of diabetes insipidus, what does the term "polydipsia" refer to?
In the context of diabetes insipidus, what does the term "polydipsia" refer to?
What is the significance of skin turgor in diagnosing diabetes insipidus?
What is the significance of skin turgor in diagnosing diabetes insipidus?
What is the typical urine specific gravity in patients with diabetes insipidus?
What is the typical urine specific gravity in patients with diabetes insipidus?
Which of the following is NOT a characteristic of hypovolemic shock?
Which of the following is NOT a characteristic of hypovolemic shock?
Flashcards
Diabetes Insipidus (DI)
Diabetes Insipidus (DI)
A condition characterized by insufficient ADH, leading to inability to concentrate or retain water.
Neurogenic Diabetes Insipidus
Neurogenic Diabetes Insipidus
A type of DI caused by insufficient production of ADH by the hypothalamus or ineffective secretion by the posterior pituitary.
Nephrogenic Diabetes Insipidus
Nephrogenic Diabetes Insipidus
A type of DI where the kidneys do not respond properly to ADH, despite its normal levels.
Dipsogenic Diabetes Insipidus
Dipsogenic Diabetes Insipidus
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Polyuria
Polyuria
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Polydipsia
Polydipsia
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Signs of Dehydration
Signs of Dehydration
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Diagnostic Criteria for DI
Diagnostic Criteria for DI
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Study Notes
Diabetes Insipidus
- Diabetes insipidus is characterized by insufficient antidiuretic hormone (ADH), leading to inability to concentrate or retain water.
Pathophysiology
- Causes:
- Neurogenic DI: Insufficient ADH production by the hypothalamus or ineffective secretion by the posterior pituitary. Possible causes include tumors, trauma, surgery.
- Nephrogenic DI: Inadequate kidney response to ADH. Possible kidney diseases, drugs (lithium)
- Dipsogenic/Psychogenic DI: Water intoxication (drinking excessive amounts of water) which lowers osmolality below ADH secretion threshold.
Clinical Manifestations
- Severity dependent: Polyuria (excessive urination)- highly dilute urine with low specific gravity. Fluid loss leads to serum hyperosmolality, severe dehydration, and excessive thirst (polydipsia)
- Untreated, can result in hypovolemic shock and death.
Diagnostic Criteria
- History and physical examination: Frequent causes include surgery, trauma, and signs of dehydration (skin turgor, sticky oral mucosa, dry flushed skin).
- Laboratory tests:
- Elevated serum osmolality (280-300mOsm/kg).
- Elevated or low ADH levels.
- Urine specific gravity < 1.005.
- Urine osmolality < 200mOsm/kg.
Treatment
- Treat underlying cause (if possible).
- Hydration: Priority; providing enough water to quench thirst.
- Pharmacologic treatment (if needed):
- Desmopressin (vasopressin analog): acts as an antidiuretic, may be lifelong medication.
- Most patients can drink enough water.
- IV hydration (if necessary): For patients with inadequate thirst mechanism, hypotonic solutions may be administered.
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