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Endocrine > 2: SIADH > Flashcards

2: SIADH Flashcards

1
Q

Where is ADH released from

A

Posterior pituitary gland

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2
Q

What is SIADH

A

Syndrome excess ADH secretion

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3
Q

What are the 5 aetiological categories of SIADH

A
  1. Malignancy
  2. Neurological
  3. Infection
  4. Medication
  5. Other
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4
Q

What 3 malignancies can cause SIADH

A
  • Pancreatic cancer
  • Prostate cancer
  • Squamous cell carcinoma
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5
Q

What are 4 neurological causes of SIADH

A
  • SAH
  • Subdural haemorrhage
  • Stroke
  • Meningitis
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6
Q

What other metabolic anomaly can occur following trauma or cerebral tumours

A

Cerebral salt waisting

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7
Q

What is cerebral salt wasting

A

Loss of sodium and hence water following tumour or trauma

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8
Q

What medications can cause SIADH

A
  • Sulfonylurea
  • SSRI
  • Tricyclines
  • Carbamazepine
  • Vincristine
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9
Q

What is another cause of SIADH

A

PEEP

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10
Q

What are 4 mild symptoms of SIADH

A
  • Nausea and Vomiting
  • Anorexia
  • Headache
  • Muscle Cramps
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11
Q

What are 3 moderate symptoms of SIADH

A
  • Muscle weakness
  • Lethargy
  • Confusion
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12
Q

What are 2 severe symptoms of SIADH

A
  • Seizures

- Altered consciousness

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13
Q

What is the MOA of ADH on the kidney

A

ADH increases aquaporin-2 channels and water re-absorption

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14
Q

What metabolic abnormality is found in SIADH and why

A

Dilutional hyponatraemia

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15
Q

What is a complication of SIADH

A

Causes cerebral oedema- which can lead to raised ICP

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16
Q

What investigations are ordered in SIADH

A

U+E
Serum osmolality
Urine osmolality

17
Q

How wil U+E present

A

Hyponatraemia

Due to increase water retention

18
Q

Describe plasma osmolality

A

Low - secondary to dilution

19
Q

Describe urine osmolality

A

High - due to increased water reabsorption concentrating urine

20
Q

Describe urine sodium excretion

A

High

21
Q

If asymptomatic how is SIADH managed

A

Restrict fluid-intake

22
Q

If symptomatic, how is SIADH managed

A
  1. Hypertonic Saline Solution (Correct Sodium)

2,. Fluid Restriction

  1. Demeclocycline
23
Q

Why should hypertonic saline solution be infused slowly

A

Avoid cerebral pontine myelinolysis - caused by too rapid correction of hyponatraemia

24
Q

What is demeclocycline

A

Reduces sensitivity of renal collecting tubules to ADH

Endocrine (20 decks)

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