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Year 3 Conditions > Polyuria > Flashcards

Polyuria Flashcards

1
Q

What is important thing in history to ascertain for polyuria

A

If actually polyuria or increased frequency. Ask about whether high volume or if the urine is often clear

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2
Q

What is test to determine if actually polyuria

A

24hr urine collection. Polyuria if over 3L

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3
Q

DDx for polyuria

A 
DM
Diuretics
HF
Hypercalcaemia
Hyperthyroidism
Primary polydipsia
Hypokalaemia
Diabetes insipidus
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4
Q

How does cushings and steroids lead to polyuria

A

Cause DM

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5
Q

How does hypercalcaemia cause polyuria

A

Nephrogenic diabetes insipidus

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6
Q

How can chronic renal failure cause polyuria

A

Nephrogenic diabetes insipidus

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7
Q

How does hypokalaemia cause polyuria

A

Nephrogenic diabetes insipidus

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8
Q

Why do you wee less at night

A

As the intake of luid is zero the body retains all the fluid making the urine very concentrated

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9
Q

Why is nocturia relevant in polyuria

A

Shows the kidneys inability to concentrate the urine thus excluding primary polydipsia

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10
Q

Why are LUTS symptoms relevant in polyuria

A

Probably not truly polyuria but increased frequency instead

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11
Q

Why is change in urine colour and smell relevant in polyuria

A

Is as a result of UTI instead most likely

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12
Q

How is PMH relevant in polyuria history

A

Look for things that could cause renal problems- vasculitides, HTN, chronic urinary retention
Cancer could lead to hypercalcaemia

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13
Q

Relevance of drugs in polyuria history

A

Diuretics

Lithium leading to nephrogenic polyuria

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14
Q

Fatigue and weight loss relevance in polyuria history

A

Diabetes Mellitus

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15
Q

Investigations ordered for polyuria

A 
Capillary glucose- diabetes
Urinalysis- exclude UTI
Urine osmolality
U&Es
Calcium
Thyroid function
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16
Q

What are 2 mechanisms that cause polyuria

A

Inability to reabsorb solutes so they remain in urine and water follows
Inability to reabsorb water either DCT pathology or ADH system impairment

17
Q

What is difference in urine osmolality between 2 mechanisms causing polyuria

A

Inability to reabsorb solutes- 300mosm

ADH deficiency- under 250mosm

18
Q

What will be main electrolyte abnormality in primary polydipsia

A

Hyponatraemia

19
Q

How to differentiate primary polydipsia from all other polyuria causes

A

In primary polydipsia will be hyponatraemia but in others hypernatraemia

20
Q

Cranial causes of DI

A 
Surgery
Vacular lesion
Mets
Pituitary tumours
Craniopharyngioma
21
Q

Investigation order for polyuria leading to diagnosis

A

Check glucose
If normal check urine osmolality
If high then due to kidney inability to reabsorb solutes due to drugs etc
Then check serum sodium- if low psychogenic polydipsia
Then water deprivation test with desmopressin

22
Q

Recurrent infections to genitals in polyuria history

A

DM

23
Q

What ABs are found early on in T1DM patients

A

Anti glutamic decarboxylase

24
Q

Causes of DKA

A

First time diagnosis with T1DM
Ilness
Poor compliance with insulin

25
Q

Why does illness cause DKA

A

Increase in cortisol in response thus raising insulin threshold needed to control blood sugar

26
Q

If bone pain what must exclude

A

Metastases

Myeloma

27
Q

What class of drug is metformin

A

Biguanide

28
Q

What is MOA of alpha glucosidase

A

Decrease glucose absoprtion in intestine

29
Q

What causes HHS

A

First time diagnosis of T2DM
Poor compliance with diabetes meds
IIllness

30
Q

What are 2 mechanisms of complication in HHS

A

Extravascular fluid shift to intravascular thus causing intracellular dehydration
Osmotic diuresis leading to hypovolaemia

31
Q

Main risks of hypovolaemia

A

Shock
Thrombous
Neuro impairment

Year 3 Conditions (33 decks)

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