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ELM3 - endocrine > antidiuretic hormone > Flashcards

antidiuretic hormone Flashcards

1
Q

Where is ADH produced?

A

The hypothalamus (but released by the posterior pituitary)

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2
Q

What are the 2 key stimuli for ADH release?

A
  1. Increased plasma osmolarity, detected by osmoreceptors in the hypothalamus
  2. decreased blood volume/pressure, detected by receptor blood vessels
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3
Q

What are the actions of ADH?

A

Insert aquaporins into the distal convoluted tubules and collecting ducts of the kidneys to increased water reabsorption.
Vasoconstrict blood vessels to increase blood pressure

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4
Q

What are the 2 key sites of action for ADH?

A

Kidneys (DCT, CDs), Blood vessels

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5
Q

What are the negative feedback loops regulating ADH secretion?

A

ADH increases renal water reabsorption which decreases blood osmotic pressure, which reduces ADH secretion from the hypothalamus.
ADH also causes vasoconstriction which increases blood pressure, also reducing ADH secretion./

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6
Q

What is the main disorder of ADH secretion?

A

Diabetes Insipidus

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7
Q

What is Diabetes Insipidus?

A

An inability to concentrate urine due to insufficient action of ADH

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8
Q

What are the 2 types of Diabetes Insipidus?

A

Central/Neurogenic Diabetes Insipidus, Nephrogenic Diabetes Insipidus

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9
Q

What is Central/Neurogenic Diabetes Insipidus?

A

Insufficient secretion of ADH by the hypothalamus/posterior pituitary due to head trauma, brain tumors, infection, etc.

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10
Q

What is Nephrogenic Diabetes Insipidus?

A

Kidney is unable to respond to ADH, depite normal or raised levels. Often caused by genetic conditions, CKD, electrolyte imbalances, medications (particularly lithium), renal calculi

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11
Q

What is Dipsogenic Diabetes Insipidus?

A

Excessive fluid intake causes excessive urination, often due to damage to the thirst regulation centres of the hypothalamus

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12
Q

What are the symptoms of Diabetes Insipidus?

A

polyuria, polydipsia, nocturia, dehydration, fatigue

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13
Q

What is the expected urine osmolarity in Diabetes Insipidus?

A

Low osmolarity (very dilute urine)

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14
Q

What is the expected plasma osmolarity in Diabetes Insipidus?

A

Elevated due to dehydration

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15
Q

How is the water deprivation/desmopressin test used to differentiate between the causes of Diabetes Insipidus?

A

In central/neurogenic Diabetes Insipidus, urine output will remain high until synthetic ADH is given, where it will decrease.
In nephrogenic Diabetes Insipidus, urine output will remain high even after desmopressin is administered

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16
Q

What is the treatment for Central Diabetes Insipidus?

A

Desmopressin nasal spray/tablet/injection, maintaining hydration

17
Q

What is the treatment for nephrogenic Diabetes Insipidus?

A

Thiazide diuretics, low-sodium diet, maintaining hydration

ELM3 - endocrine (10 decks)

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