Antidiuretic Hormone

Question 1

Where is ADH released from

Answer 1

posterior pituitary

Question 2

ADH is released in response to

Answer 2

either low BP or increased salt concentrations

Question 3

Two conditions that alter ADH levels

Answer 3

SIADH

diabetes insipidous

Question 4

Other causes of elevated ADH

Answer 4

infection/tumors in CNS or lungs
fluid imbalances after surgery
acute porphyria

Question 5

Other causes of depressed ADH

Answer 5

damage to pituitary gland

primary polydipsia

Question 6

SIADH high or low levels of ADH?

Answer 6

higher than normal

Question 7

Consequences of ADH

Answer 7

increase water reabsorption
which will increase blood pressure
by increasing blood volume

Question 8

Diabetes insipidus high or low levels of ADH?

Answer 8

lower than normal

Question 9

ADH is also known as

Answer 9

vasopressin

Question 10

Conditions associated with SIADH

Answer 10

infections (meningitis)
head injury (subarachnoid hemorrhage)
cancers (small cell lung CA)
drugs (SSRI’s)

Question 11

What is ADH released in response to

Answer 11

low bloodpressure

increased salt concentrations

Question 12

Main function of ADH

Answer 12

controls reabsorption of water by kidneys

Question 13

Consequences of SIADH

Answer 13

water retention
increase BP
increase ECF volumes

Question 14

Fluid overload in SIADH causes

Answer 14

hyponatremia

Question 15

S/Sx of SIADH

Answer 15

effects of hyponatremia
headaches
nausea/vomiting
confusion
severe: convulsions or coma

Question 16

Name treatments for SIADH

Answer 16

water restriction
demeclocycline (tetracycline drug blocks effect of ADH)
management of underlying cause
diuretics for fluid retention

Question 17

Dilution syndrome or fluid overload are results of

Answer 17

SIADH

Question 18

Condition in which the kidneys are unable to conserve water

Answer 18

Diabetes insipidus

Question 19

S/Sx of diabetes insipidus

Answer 19

excessive thirst
large amounts of very dilute urine
loss of potassium
severe dehydration
heart failure

Question 20

Two forms of DI

Answer 20

central/neurogenic

nephrogenic

Question 21

Form of DI caused by lack of ADH due to damage to hypothalamus or pituitary gland

Answer 21

Central/neurogenic

Question 22

Inherited Central DI involves mutations of what?

Answer 22

AVP gene which encodes vasopressin or ADH

autosomal dominant pattern

Question 23

Treatments for central DI

Answer 23

Drinking more water

DDAVP (form of vasopressin)

Question 24

Form of DI involving defect in the parts of kidneys/nephrons that reabsorb water into blood stream causing limited availability for ADH to work at target site

Answer 24

Nephrogenic DI

Question 25

X-linked defect that causes vasopressin receptor in kidney not to reply

Answer 25

inherited nephrogenic DI

Question 26

Inherited nephrogenic DI is there enough ADH being produced?

Answer 26

Yes | it is the receptor that is not able to signal appropriately

Question 27

Drugs that can cause nephrogenic DI

Answer 27

lithium, amphotericin B, demeclocyline

Question 28

Other causes of nephrogenic DI

Answer 28

drugs high calcium polycystic kidney disease

Question 29

Gene that forms water channels

Answer 29

AQP2 aquaporin-2 mutation of gene prevents water reabsorption seen in nephrogenic DI

Question 30

Decreased water reabsorption leads to

Answer 30

polyuria | polydipsia

Question 31

Lithium toxicity involves

Answer 31

decreasing second messengers that signal AQP2 water channels upon ADH stimulation reduces number of water channels thus reducing ablility to reabsorb water causing polyuria

Question 32

treatment of nephrogenic DI

Answer 32

drinking enough fluids to match urine output with drugs that lower urine output low-salt and low-protein diet

Question 33

Causes of Central/neurogenic DI

Answer 33

head injury or cranial surgery, pituitary surgery

Question 34

True or false: Vasopressin in given to pts with nephrogenic DI

Answer 34

False It is given to pts with central or neurogenic because there is a lack of ADH If given in nephrogenic, no effect because something is wrong with the nephrons

Question 35

Posterior pituitary not producing enough ADH is it neurogenic or nephrogenic?

Answer 35

Neurogenic or central

Question 36

Both types of DI respond partially to what type of diuretics

Answer 36

thiazide

Question 37

agonist for vasopressin which allows for rectification ADH deficit

Answer 37

DDAVP

Question 38

With DI persons are unable to

Answer 38

concentrate urine

Question 39

osmolar concentration in 1L of solution

Answer 39

Osmolarity

Question 40

osmolar concentration in 1kg of water

Answer 40

Osmilality

Question 41

measurement of urine concentration

Answer 41

urine osmolality

Question 42

Normal urine osmolality values

Answer 42

50 to 1200 milliosmoles per kilogram (mOsm/kg) | 12 to 14 hour fluid restriction: Greater than 850 mOsm/kg

Question 43

What happens to UO and urine osmolality with polydipsia

Answer 43

urine output increases | urine osmolality is dilute d/yt the increase in water intake, and is generally less than 100 mOsm/kg