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NUR 326 - GI and Endocrine > SIADH and DI > Flashcards

SIADH and DI Flashcards

1
Q

what does SIADH stand for

A

syndrome of inappropriate antidiuretic hormone

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2
Q

what is SIADH

A

abnormal production of sustained secretion of ADH
Think “soaked inside”
“Low Liquidity Labs”

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3
Q

how is SIADH characterized

A

fluid retention
serum hypoosmolality
hyponatremia
concentrated urine

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4
Q

what does ADH signal the kidneys to do?

A

hold fluid

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5
Q

When is SIADH self limiting?

A

drug related or head injury

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6
Q

when is SIADH chronic?

A

cancer

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7
Q

what causes SIADH?

A

malignant tumors “small cell lung cancer”
head trauma, stroke, brain tumors
morphine, SSRI’s, some chemos
Hypothyroidism, infection

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8
Q

SIADH pathophysiology map (4 steps)

A
  1. increased ADH
  2. increased water absorption in renal tubules
  3. increased intravascular fluid volume
  4. dilutional hyponatremia and decreased serum osmolality
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9
Q

what is the song that goes along with SIADH?

A

lung tumors, trauma, and bad bugs a complication might be, SIADH, SIADH, SIADH, this hormone stops the PEE PEE
low output, sodium; gained weight and high specific gravity, SIADH, SIADH, SIADH, this hormone stops the PEE PEE

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10
Q

What osmolality is low with SIADH?

A

serum, sodium,urine

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11
Q

what osmolality is high with SIADH?

A

urine specific gravity

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12
Q

do you gain or loose weight with SIADH?

A

gain

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13
Q

in SIADH your patient is retaining ____ ____, without ____

A

pure water; salt

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14
Q

manifestations of SIADH depend on

A

severity and onset of hyponatremia

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15
Q

clinical manifestations of SIADH

A

hyponatremia causing dyspnea and fatigue
neurological- dulled sensations, confusion, lethargy, muscle twitching, convulsions
GI- impaired taste, no appetite, vomiting, abd cramps

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16
Q

what serum sodium level indicates hypovolemic shock and what does this cause?

A

Na+ less than 100-115

irreversible neurologic damage

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17
Q

can you die of water intoxication?

A

YES

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18
Q

what is water toxicity and how does this happen and what cells are primarily effected?

A

excessive intake of water, serum sodium is super low causing cells to swell, especially in the brain causing increased intracranial pressure. can be deadly

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19
Q

is pharmacotherapy the first line of tx for SIADH?

A

Nope, tx is directed at the underlying cause

ex: discontinuing offending med

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20
Q

what do you treat chronic SIADH with?

A

demeclocycline
used in cancer patients
can counteract SIADH

21
Q

What is Diabetes Insipidus? (DI)

A

deficiency of ADH
decreased renal response to ADH
think “ DRY INSIDE”

22
Q

what is DI characterized by?

A

excessive loss of water in urine
increased thick blood
increased urine output

23
Q

what are the two forms of DI?

A

neurogenic (central)

Nephrogenic

24
Q

what is neurogenic (central DI?)

A

tumor in the brain
hypothalamus or pituitary gland damage
SUDDEN onset
usually PERMANET

25
Q

what is nephrogenic DI?

A 
kidneys not responding to ADH
loss of kidney function
often drug related (lithium)
onset- SLOW
course of disease-PROGRESSIVE ( as kidney function worsens symptoms increase)
26
Q

what disorders are associated neurogenic DI

A

stroke
traumatic brain injury
brain surgery
cerebral infections

27
Q

what disorders are associated with nephrogenic DI

A

CKD

28
Q

pathophysiology map of DI- 5 parts

A
  1. decreased ADH
  2. Decreased water reabsorption in renal tubules
  3. decreased intravascular fluid volume
  4. HYPERNATREMIA
  5. excessive urine output
29
Q

what osmolality is low with DI?

A

urine

30
Q

do you gain or loose weight with DI?

A

loose

31
Q

What osmolality is high with DI?

A

serum, sodium

32
Q

is urine output high or low with DI?

A

high

33
Q

clinical manifestations of DI

A 
polyuria
polydipsia
dehydration
electrolyte imbalances
hypovolemic shock/death
"drinking themselves to death, peeing themselves to death"
34
Q

what is pharmacology tx for neurogenic DI?

A

synthetic ADH replacement

desmopressin

35
Q

what do you use to treat nephrogenic DI?

A

thiazide diuretics

36
Q

why are diuretics used in someone who is peeing constantly?

A

paradoxical effect

decreased polyurina, increases osmolality

37
Q

what is the song for DI?

A

Diabetes insipidus the opposite you’ll see PEE PEE, GIVE IV’s.; PEE PEE GIVE IV’s, PEE PEE GIVE IV’s; desmopressin they need!

38
Q

What does D-I-L-U-T-E stand for in DI

A 
DRY
I and O daily weight
Low specific gravity
Urinate lots
Treat= vasopressin
rEhydrate
39
Q

hyperthyroidism

A

excessive secretion of T3 and T4

has 3 times primary, secondary, tertiary

40
Q

primary hyperthyroidism

A

thyroid gland over producing T3 and T4

GRAVES disease

41
Q

secondary hyperthyroidism

A

pituitary
uncommon
pituitary gland over produces

42
Q

tertiary hyperthyroidism

A

hypothalamus

excessive secretion from hypothalamus

43
Q

graves disease

A

most common hyperthyroidism
AUTOIMMUNE stimulation of thyroid gland
excessive T3 and T4
thyroid stimulating antibodies causing gland to enlarge

44
Q

other causes of hyperthyroidism

A

thyroid adenoma, subacute thyroiditis, toxic multinodular goiter, excessive iodine ingestion, excessive hormone production

45
Q

risk factors for hyperthyroidism

A 
fx of graves
greater than 40
women
Caucasian
AMIODERONE
excessive iodine intake
pregnancy
46
Q

symptoms of Graves Disease

A 
nervousness
insomnia
sensitivity to heat
weight loss
audible bruit over thyroid
afib
myxedema
exophthalmos
47
Q

exophthalmos

A 
thyroid eye disease
bulging eyes
wide-eye stare
periorbital edema
Graves ophthalmopathy
women often effected
48
Q

graves is diagnosed by

A 
LOW tsh
HIGH T3 and T4
antithyroglobulin
antithyrotropin receptor antibody
US with color doppler
radioactive iodine scan with measurements of iodine uptake

NUR 326 - GI and Endocrine (6 decks)

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