Diabetes Insipidus Flashcards

1
Q

Post op patients at risk for DI

A

post op neuro sx for craniopharyngioma or other sx in the pituitary/hypothalamus region , TBI, ischemic brain injury, conditions causing acute brain swelling

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2
Q

Post op management for patients at risk DI

A

Na, K, Osmol, glu, BUN, creat post op and q2h, urine cath, ins and outs, notify MD if UO >4mL/kg/h over 2h or Na <138/>145

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3
Q

Post Op craniopharyngioma patients are at higher risk of

A

ACTH deficiency (90%) treat with hydrocortisone pre op/post op until well. ACTH stim test as outpt

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4
Q

1 mg decadron - X mg hydrocortisone

A

30mg

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5
Q

Diagnostic criteria central DI

A

UO >4 ml/kg/h over 2h, Na >145, Urine SG <1.005 or urine Osmol <300 mOsm/kg
Support: plasma osmol >290 mOsm/kg, no glycosuria, no renal failure

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6
Q

Treatment central DI

A

q2h lytes/BUN/creat, D5NS and 40 meq/L KCl at 400 mL/m2/day (insensible losses). Replace urine loss 1:1
if urine Na >150 give D5NS, 150-50 give D51/2NS, <50 give D5W, DDAVP 1mcg/m2/d increasing q30min until UO = 1-2 *only increase if pt still meets DI criteria. Monitor Na closely. Thyroid function one week post op.

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