Flashcards in 23. Polyuria Deck (14)
What are Dx of polyuria?
Diuretics (e.g. diuretic meds., caffeine, alcohol, lithium)
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
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
Drug history in polyuria
Lithium (causes nephrogenic DI)
Family history in polyuria
What are simple tests in someone with polyuria?
Capillary blood glucose
What are further Ix for polyuria?
Electrolytes (primary polydypsia will have hypOnatremia)
How do you differentiate between the 2 types of diabetes insipidus them?
Water deprivation test + give desmopressin.
Normal urine osmolality: cranial
Low urine osmolality: nephrogenic
What are causes of cranial DI?
What is management of cranial DI?
Adequate fluid intake
Give ADH replacement
What is polyuria?
Passing abnormally large volumes of clear urine
What can cause nephrogenic diabetes insipidus?
Chronic renal failure
Hypercalcaemia (bone mets.)
Drugs e.g. Litium
What is the difference between cranial and nephrogenic diabetes insipidus?
Cranial: Reduced/ absent secretion of ADH
Nephrogenic: ADH insensitivity