Diabetes Insipidus Flashcards

1
Q

What is diabetes insipidus?

A

Lack of ADH or lack of response to ADH

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2
Q

What does lack of ADH prevent kidney form doing?

A

Being able to concentrate urine leading tp polyuria and polydipsia

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3
Q

What are the classifications of diabetes insipidus?

A

Nephrogenic

Cranial

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4
Q

What is nephrogenic?

A

When collecting ducts of kidneys dont respond to ADH

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5
Q

What can cause nephrogenic Diabetes insipidus?

A

Drugs: Lithium for bipolar
AVPR2 Mutation on X chromosome: codes for ADH receptor
Intrinsic kidney disease
Electrolyte disorders

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6
Q

What is cranial diabetes insipidus?

A

When hypothalamus doesn’t produce ADH for pituitary gland to secrete

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7
Q

Causes of cranial diabetes?

A

Can be idiopathic or

  • Brain tumours
  • Head injury
  • Brain malformations/infections
  • Surgery/radiotherapy
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8
Q

Presnetation of diabetes insipidus?

A
  • Polyuria
  • Polydipsia
  • Dehydration
  • Postural hypotension
  • Hypernatremia
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9
Q

Investigations of diabetes insipidus?

A
  • Low urine osmolality
  • High serum osmolality
  • Water deprivation test
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10
Q

Water deprivation test AKA?

A

Desmopressin test

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11
Q

Method of desmopressin test?

A
  • AVoid fluid for 8 hours
  • Measure urine osmolality and administer synthetic ADH
  • Measure osmolality 8 hours later again
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12
Q

Results for cranial diabetes insipidus desmopressin test?

A

Initially urine osmolality remains low as it continues to be diluted by XSive water secretion in kidneys
When synth ADH is given, kidneys respond & reabsorb water, concentrating urine= High osmolality

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13
Q

Why the results occur that way in cranial diabetes insipidus?

A

Patient lacks ADH

Kidneys can still respond to it

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14
Q

Nephrogenic respose to desmopressin test?

A

Low osmolarity (diluting urine with XSive water from kidneys)

Remains low after synthetic ADH as well

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15
Q

Why the results occur that way in nephrogenic diabetes insip?

A

Patient unable to respond to ADH

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16
Q

Primary polydipsia results in desmopressin test?

A

8 hours of water deprivation = high urine osmolality before synthetic ADH

17
Q

High urine osmolality after 8 hours?

A

No diabetes insipidus

18
Q

Osmolality of cranial diabetes insipidus in desmopressin test before and after 8 hours?

A

After deprivation= Low

After ADH= High

19
Q

Osmolality of nephrogenic diabetes after deprivation and after ADH?

A

After deprivation = Low

After ADH = Low

20
Q

Primary polydipsia urine osmolality after deprivation and after ADH?

A

After deprivation = High

After ADH = High

21
Q

Management of diabetes insipidus?

A

Desmopressin (Synth ADH)

  • Cranial diabetes to replace ADH
  • Nephrogenic diabetes in HIGH doses under close monitoring