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2a- Endocrinology > Water balance, diabetes Insipidus and hyponatraemia > Flashcards

Water balance, diabetes Insipidus and hyponatraemia Flashcards

1
Q

How much fluid is in ECF?

A

1/3 of total body water
14L

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2
Q

How much fluid is in intravascular fluid?

A

1/4 ECF
3.5L

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3
Q

How much fluid is in interstitial fluid?

A

3/4 ECF
10.5L

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4
Q

How much fluid in ICF?

A

2/3 total body water
28L

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5
Q

What is the main cation in ECF?

A

Na+

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6
Q

What is the main cation in ICF?

A

K+

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7
Q

What is the main anion in ECF?

A

Cl-

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8
Q

What is the main anion in ICF?

A

(PO3-)4 and organic anions

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9
Q

What is the release of vasopressin (ADH) controlled by?

A
  • Osmoreceptors in hypothalamus controls release day to day
  • Baroreceptors in brainstem and great vessels release ADH in emergencies
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10
Q

What is osmolality?

A

concentration per kilo
- in plasma very similar to osmolarity but concentration slightly different

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11
Q

What are the features of diabetes insipidus (AVP deficiency and resistance)?

A
  • polyuria
  • polydypsia
  • no glycosuria
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12
Q

How would you diagnose diabetes insipidus?

A
  • measure urine volume
    • DI unlikely if urine volume <3L/day
  • serum osmo >300 AND urine osmo<200
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13
Q

Why would you measure copeptin?

A
  • Copeptin can be measured to measure AVP as it is cleaved when vasopressin is synthesised
  • Measuring vasopressin is difficult as it is quickly metabolised and unstable
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14
Q

Define hyponatraemia

A

Definition: serum sodium <135 mmol/l

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15
Q

What is a biochemically severe hyponatraemia?

A

serum sodium <125 mmol/l

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16
Q

What are the normal bounds for serum sodium?

A

serum sodium 135-144mmol

17
Q

What is considered acute hyponatremia?

A

<48 hours

18
Q

What are causes of cranial diabetes insipidus (DI) - (lack of vasopressin)?

A
  • Idiopathic
  • Trauma
  • Tumours
  • Genetic
  • Vascular – aneurysms, infarction
19
Q

What is considered chronic hyponatremia?

A

> 48 hours

20
Q

How would you manage cranial DI?

A
  • Treat any underlying condition
  • Desmopressin
    • Tablets
    • Nasal spray
    • Injection
21
Q

What are the signs and symptoms of cranial DI?

A
  • Headache
  • Lethargy
  • Anorexia and abdominal pain
  • Weakness
  • Confusion/ hallucinations
22
Q

What are some tests for hyponatraemia?

A
  • Plasma osmolality
  • Urine osmolality
  • Plasma glucose
  • Urine sodium
  • Cortisol

2a- Endocrinology (17 decks)

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