23. Polyuria Flashcards Preview

YR3: MM FC Ed. > 23. Polyuria > Flashcards

Flashcards in 23. Polyuria Deck (14)
Loading flashcards...
1

What are Dx of polyuria?

Diabetes Mellitus
Diuretics (e.g. diuretic meds., caffeine, alcohol, lithium)
Heart Failure
Hypercalcaemia
Hyperthyroidism
Primary Polydipsia
Hypokalaemia
Diabetes Insipidus

2

What questions will help you narrow down the cause of polyuria?

What is the temporal pattern of urine output?
Fatigue, weight loss, recurrent infections? (diabetes)
LUTS? frequency, urgency, hesitance, terminal dribbling, incomplete voiding
Pain, frequency, colour, smell? UTI

3

What will you ask about on PMH of polyuria?

History of renal problems or triggers of renal problems? vasculitides, urinary retention, hypertension
Older patients: ask about cancer + known bony involvement
Any psychiatric disorders

4

Drug history in polyuria

Diuretics
Lithium (causes nephrogenic DI)

5

Family history in polyuria

Diabetes
Any cancers

6

What are simple tests in someone with polyuria?

Capillary blood glucose
Urinalysis

7

What are further Ix for polyuria?

Fasting glucose
Urine osmolality,
Electrolytes (primary polydypsia will have hypOnatremia)
Urea
Creatinine
EGFR
Calcium
TFTs

8

How do you differentiate between the 2 types of diabetes insipidus them?

Water deprivation test + give desmopressin.
After DDAVP:
Normal urine osmolality: cranial
Low urine osmolality: nephrogenic

9

What are causes of cranial DI?

Pituitary tumours
Cranipharyngiomas
Trauma
Mets
Vascular lesions
Meningitis

10

What is management of cranial DI?

Adequate fluid intake
Investigate cause
Give ADH replacement

11

What is polyuria?

Passing abnormally large volumes of clear urine

12

What can cause nephrogenic diabetes insipidus?

Chronic renal failure
Hypercalcaemia (bone mets.)
Hypokalemia
Drugs e.g. Litium
Pyelonephritis
Hydronephrosis
Inherited

13

What is the difference between cranial and nephrogenic diabetes insipidus?

Cranial: Reduced/ absent secretion of ADH
Nephrogenic: ADH insensitivity

14

What is primary polydipsia? What group of patients is it more common in?

Psychogenic polydipsia: excessive volitional water intake
Those with a hx psychiatric disorders