Endocrinology - ADH and Calcium Flashcards Preview

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Flashcards in Endocrinology - ADH and Calcium Deck (69)
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1

What is polyuria?

Increased urine production - 50 ml/kg/day

2

What is the normal urine production of a small animal?

20-45 ml/kg/day

3

What is polydipsia?

Increased thirst - 100 ml/kg/day

4

What is the normal water intake of a small animals?

20-70 ml/kg/day

5

True or false: The vast majority of animals are polydipsic first.

false - they are polyuric first

6

How does polyuria lead to polydipsia?

Polyuria leads to volume depletion which leads to polydipsia to prevent dehydration

7

True or False: Water restriction is not the answer to treat PU/PD.

TRUE

8

What are the major differential diagnoses for PU/PD?

Osmotic diuresis, diabetes insipidus, renal medullary solute washout, drug-induced, and primary polydipsia

9

What is osmotic diuresis?

It is when there is an increase in urine solutes resulting in water pulled into the tubule and thus increased water loss through the urine

10

What are some disease processes that can cause osmotic diuresis?

Diabetes mellitus/DKA, Fanconi syndrome or primary renal glucosuria, CKD/AKI, and post-obstructive diuresis

11

What is diabetes insipidus?

A disorder characterized by the production of a large amount of dilute urine that occurs when water is not able to be reabsorbed from the renal tubule (action of ADH)

12

What are the two manifestations of diabetes insipidus?

central and nephrogenic

13

What is central diabetes insipidus also known as?

primary pituitary DI

14

What is central diabetes insipidus caused by?

A lack of ADH production - there is some issue with the pituitary gland

15

What is nephrogenic diabetes insipidus?

There is partial or complete lack of renal response to ADH

16

What are the two forms of nephrogenic diabetes insipidus?

Primary and secondary/acquired

17

What is primary nephrogenic diabetes insipidus?

Congenital lack of ADH receptors or lack of response to ADH- it has not been described in small animals

18

What can cause acquired NDI?

bacterual endotoxins, hypercalcemia, hyperadrenocorticism, hypokalemia, and others

19

What is renal medullary solute washout?

The loss of renal medullary solutes due to an impaired ability of the nephron to concentrate urine

20

What are the potential causes of renal medullary solute washout?

Hepatic disease, chronic diuretic use, and many other causes of PU/PD

21

What drugs are the 'common offenders' of causing PU/PD?

Anticonvulsants, glucocorticoids, and diuretics

22

What is primary polydipsia?

It is polydipsia that cannot be explained as a compensatory response to excessive whater loss

23

What is psychogenic polydipsia?

Behavioral compulsive water consumption - diagnosis of absolute exclusion

24

Why does polyuria develop in cases of psychogenic polydipsia?

to prevent overhydration

25

What is the clinical approach to PU/PD?

Get a history to verify, do a thorough PE, do a minimum database to rule out easy causes, use a UA to look for hyposthenuria or concentrated urine, and do additional diagnostics

26

What additional diagnostics can be done to diagnose the underlying cause of PU/PD?

UCCR, LDDST, T4, imaging, urine culture, leptospirosis testing, bile acids

27

What is a Desmopressin (DDAVP) trial?

It is a synthetic ADH analog that is used to tread CDI - if given and there is a positive response it is suggestive of CDI

28

What is a water deprivation test used for?

To determine if the patient has the ability to concentrate urine

29

What is the water deprivation test used to differentiate between?

Primary/psychogenic polydipsia and diabetes insipidus

30

When should the water deprivation test only be performed?

If all other causes of PU/PD have been ruled out

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