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Renal system: pathology > Antidiuretic Hormone > Flashcards

Antidiuretic Hormone Flashcards

1
Q

Where is ADH released from

A

posterior pituitary

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2
Q

ADH is released in response to

A

either low BP or increased salt concentrations

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3
Q

Two conditions that alter ADH levels

A

SIADH

diabetes insipidous

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4
Q

Other causes of elevated ADH

A

infection/tumors in CNS or lungs
fluid imbalances after surgery
acute porphyria

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5
Q

Other causes of depressed ADH

A

damage to pituitary gland

primary polydipsia

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6
Q

SIADH high or low levels of ADH?

A

higher than normal

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7
Q

Consequences of ADH

A

increase water reabsorption
which will increase blood pressure
by increasing blood volume

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8
Q

Diabetes insipidus high or low levels of ADH?

A

lower than normal

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9
Q

ADH is also known as

A

vasopressin

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10
Q

Conditions associated with SIADH

A

infections (meningitis)
head injury (subarachnoid hemorrhage)
cancers (small cell lung CA)
drugs (SSRI’s)

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11
Q

What is ADH released in response to

A

low bloodpressure

increased salt concentrations

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12
Q

Main function of ADH

A

controls reabsorption of water by kidneys

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13
Q

Consequences of SIADH

A

water retention
increase BP
increase ECF volumes

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14
Q

Fluid overload in SIADH causes

A

hyponatremia

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15
Q

S/Sx of SIADH

A 
effects of hyponatremia
headaches
nausea/vomiting
confusion
severe: convulsions or coma
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16
Q

Name treatments for SIADH

A

water restriction
demeclocycline (tetracycline drug blocks effect of ADH)
management of underlying cause
diuretics for fluid retention

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17
Q

Dilution syndrome or fluid overload are results of

A

SIADH

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18
Q

Condition in which the kidneys are unable to conserve water

A

Diabetes insipidus

19
Q

S/Sx of diabetes insipidus

A 
excessive thirst
large amounts of very dilute urine
loss of potassium
severe dehydration
heart failure
20
Q

Two forms of DI

A

central/neurogenic

nephrogenic

21
Q

Form of DI caused by lack of ADH due to damage to hypothalamus or pituitary gland

A

Central/neurogenic

22
Q

Inherited Central DI involves mutations of what?

A

AVP gene which encodes vasopressin or ADH

autosomal dominant pattern

23
Q

Treatments for central DI

A

Drinking more water

DDAVP (form of vasopressin)

24
Q

Form of DI involving defect in the parts of kidneys/nephrons that reabsorb water into blood stream causing limited availability for ADH to work at target site

A

Nephrogenic DI

25
Q

X-linked defect that causes vasopressin receptor in kidney not to reply

A

inherited nephrogenic DI

26
Q

Inherited nephrogenic DI is there enough ADH being produced?

A

Yes

it is the receptor that is not able to signal appropriately

27
Q

Drugs that can cause nephrogenic DI

A

lithium, amphotericin B, demeclocyline

28
Q

Other causes of nephrogenic DI

A

drugs
high calcium
polycystic kidney disease

29
Q

Gene that forms water channels

A

AQP2 aquaporin-2
mutation of gene prevents water reabsorption
seen in nephrogenic DI

30
Q

Decreased water reabsorption leads to

A

polyuria

polydipsia

31
Q

Lithium toxicity involves

A

decreasing second messengers that signal AQP2 water channels upon ADH stimulation
reduces number of water channels
thus reducing ablility to reabsorb water
causing polyuria

32
Q

treatment of nephrogenic DI

A

drinking enough fluids to match urine output with drugs that lower urine output
low-salt and low-protein diet

33
Q

Causes of Central/neurogenic DI

A

head injury or cranial surgery, pituitary surgery

34
Q

True or false: Vasopressin in given to pts with nephrogenic DI

A

False
It is given to pts with central or neurogenic because there is a lack of ADH
If given in nephrogenic, no effect because something is wrong with the nephrons

35
Q

Posterior pituitary not producing enough ADH is it neurogenic or nephrogenic?

A

Neurogenic or central

36
Q

Both types of DI respond partially to what type of diuretics

A

thiazide

37
Q

agonist for vasopressin which allows for rectification ADH deficit

A

DDAVP

38
Q

With DI persons are unable to

A

concentrate urine

39
Q

osmolar concentration in 1L of solution

A

Osmolarity

40
Q

osmolar concentration in 1kg of water

A

Osmilality

41
Q

measurement of urine concentration

A

urine osmolality

42
Q

Normal urine osmolality values

A

50 to 1200 milliosmoles per kilogram (mOsm/kg)

12 to 14 hour fluid restriction: Greater than 850 mOsm/kg

43
Q

What happens to UO and urine osmolality with polydipsia

A

urine output increases

urine osmolality is dilute d/yt the increase in water intake, and is generally less than 100 mOsm/kg

Renal system: pathology (5 decks)

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