SIADH Flashcards

1
Q

What does SIADH stand for?

A

Syndrome of inappropriate antidiuretic hormone (SIADH)

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2
Q

What is SIADH due to?

A

Increased release of antidiuretic hormone (ADH) from the posterior pituitary

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3
Q

What does an increased release of ADH lead to?

A

Increased water reabsorption from the urine, diluting the blood and leading to hyponatraemia (low sodium)

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4
Q

Where is ADH made?

A

It is produced in the hypothalamus and secreted by the posterior pituitary gland

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5
Q

What is ADH also known as?

A

Vasopressin

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6
Q

What does vasopressin stimulate?

A

ADH stimulates water reabsorption from the collecting ducts in the kidneys.

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7
Q

What are the 2 main causes of increased ADH?

A

Increased secretion by the posterior pituitary
Ectopic ADH, most commonly by small cell lung cancer

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8
Q

What does SIADH result in?

A

Hyponatraemia

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9
Q

What are the symptoms of hyponatraemia?

A

Headache
Fatigue
Muscle aches and cramps
Confusion

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10
Q

What can severe hyponatraemia result in?

A

Seizures and reduced consciousness

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11
Q

What are the possible causes of SIADH?

A

Post-operative after surgery
Medications (e.g., SSRIs and carbamazepine)
Malignancy- small cell lung cancer
Brain pathologies

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12
Q

What medications can result in SIADH?

A

SSRI’s and carbamazepine

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13
Q

What malignancies can result in SIADH?

A

Small cell lung cancer

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14
Q

What brain pathologies can result in SIADH?

A

Head injury
Stroke
Intracranial haemorrhage
Meningitis

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15
Q

What are the main causes of SIADH?

A

Post-operative
SSRIs
Small cell lung cancer

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16
Q

What are the main clincial features of SIADH?

A

Euvolaemia
Hyponatraemia
Low serum osmolality
High urine sodium
High urine osmolality

17
Q

What will be low in someone with SIADH?

A

Euvolaemia
Hyponatraemia
Low serum osmolality

18
Q

What will be high in someone with SIADH?

A

High urine sodium
High urine osmolality

19
Q

Why does correction of SIADH need to be done slowly?

A

Central pontine myelinolysis (osmotic demyelination syndrome)

20
Q

What is the management of SIADH?

A

fluid restriction
demeclocycline
ADH (vasopressin) receptor antagonists

21
Q

What is the function of demeclocycline?

A

Reduces the responsiveness of the collecting tubule cells to ADH

22
Q

What is an example of a ADH (vasopressin) receptor antagonists?

A

Tolvaptan