Endocrinology 11 - SIADH Flashcards
1
Q
key test results in SIADH
A
euvolaemic hyponatraemia
high urine osmolality
high urine sodium
2
Q
5 symptoms of SIADH
A
headache fatigue muscle pains confusion severe hyponatraemia (seizures and low GCS)
3
Q
6 causes of SIADH
A
post operative from major surgery infection - atypical pneumo head injury meds - thiazide, antipsych, SSRI, NSAIDs small cell lung ca meningitis
4
Q
5 tests needed for SIADH diagnosis of exclusion
A
exclude other causes of low sodium first-
short synacthen test
check no diarrhoea, vom, burns, fistula, loads of sweating
check water intake normal
no chronic or acute kidney disease
5
Q
imaging needed with SIADH of unknown cause
A
CXR - pneumonia, abscess, lung ca
CT thorax, abdo, pelvis + MRI brain if CXR clear
6
Q
management of SIADH
A
severely fluid restrict 0.5-1L
treat cause
7
Q
what rate must sodium increase never exceed?
A
10mmol/L each 24 hrs
ideally much slower than this, especially if it has been at 120 or lower for a long time
otherwise central pontine myelinolysis
