N5315 Advanced Pathophysiology Endocrine Core Knowledge Objectives with Advanced Organizers

MISTY N5315 Advanced Pathophysiology Endocrine Core Knowledge Objectives with Advanced Organizers Disorders of the Posterior Pituitary 1. Evaluate the etiologies, clinical manifestations, and the pathophysiology of syndrome of inappropriate antidiuretic hormone and diabetes insipidus and describe the implications for clinical practice. Disease Etiology Clinical Manifestations Pathophysiology Clinical Implications Syndrome of Inappropriate Antidiuretic Hormone medications such as barbiturates, general anesthesia, nicotine, morphine, antidepressants, antipsychotics, and chemotherapy. water retention and fluid overload. Signs and symptoms include: dilutional hyponatremia, low plasma osmolality, decreased urine output, high urine specific gravity (concentrated urine), urine sodium > 20, urine osmolality > 100, weight gain, edema is usually absent, thirst, impaired taste, anorexia, dyspnea, fatigue and abdominal cramps may also be present. unregulated, excess secretion of antidiuretic hormone (ADH). ADH is one of the many factors which regulate water balance. provides the necessary signal to the kidneys to trigger renal water conservation. Adenocarcinoma of the lungs is the most common malignancy which causes SIADH first five-seven days post-op, the secretion of ADH is increased. Managed with free water restricition. (900ml/day) NO NORMAL SALINE. WORSEN HYPONATREMIA. USE HYPERTONIC SALINE. Diabetes Insipidus Neurogenic Dispogenic nephrogenic POLYURIA POLYDIPSIA-thirst dilute urine and an increased serum osmolality. Urine output can be excessive and over 12 liters daily. dehydrated and include: thirst, low urine osmolality, high plasma osmolality, urine sodium < 20, and hypernatremia. decrease in the secretion of ADH. The effect of this lack of hormone results in characteristics which are opposite of SIADH. Neurogenic or central DI-absence of ADH which occurs secondary to presence of hypothalamic or pituitary gland lesion. blocks the production of ADH nephrogenic DI- secretion of ADH is sufficient, but the renal tubules in the kidneys do not respond to ADH. usually permanent red or genetic. Acquired = pyelonephritis. Genetic = polycystic kidney disease. Dispogenic- excess ingestion of water The over-ingestion of water suppresses ADH secretion. often seen psychiatric diagnosis. Thyroid Disorders 2. Differentiate between the etiology, clinical manifestations, pathophysiology and complications of thyroid disorders.