Homeostasis II Revisit

Question 1

Osmotic demyelinating syndrome

Answer 1

Demyelinating syndrome that occurs when chronic hyponatremia is corrected too rapidly (over 6 mEq/day).

Note that this is only for chronic hyponatremia: acute hyponatremia may be corrected more quickly, within ~24 hours, so long as you know the patient’s baseline and don’t overshoot.

Question 2

Causes of SIADH

Answer 2

Question 3

Why are severely dehydrated patients often hyponatremic?

Answer 3

Because vasopressin has been activated to defend the blood pressure at the expense of the serum osmolarity.

Question 4

Strategies for addressing hyponatremia in SIADH

Answer 4

Question 5

What kinds of acidosis is it not safe to give bicarbonate for?

Answer 5

Lactic acidosis and diabetic ketoacidosis

Because, when metabolism is corrected in these cases, these molecules will be metabolized into more bicarbonate!

Question 6

Mechanisms of various diuretics

Answer 6

Question 7

Things that can alter HbA1c

Answer 7

Question 8

Behavioral recommendations for patients with symptomatic BPH

Answer 8

• Void in the sitting position rather than standing
• Avoiding fluids prior to bedtime or before going out
• Reducing consumption of mild diuretics such as caffeine and alcohol
• Double voiding to empty the bladder more completely