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Flashcards in Endocrine Deck (5)
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1

SIADH

-excess of ADH with increased permeability of renal distal tubule and collecting ducts results in increased water reabsorption and decreased urine production
-lab findings: serum Na <135, serum osmo <280, urine Na >30, urine osmo >200, urine spec gravity >1.020, urine output = 1ml/kg/hr
-management: restrict sodium, restrict fluid, normal saline, diuretics, monitor electrolytes
-causes: CNS injury, hypothalamus or pituitary issue, hepatic disease, high dose chemo

2

Diabetes Insipidous

-antidiuretic effect, inadequate levels of antidiuretic hormone results in decreased water reabsorption, increase urine output, hypernatremia and dehydration
-lab findings: serum Na >150, serum osmo >295, urine Na <30, urine osmo <200, urine spec gravity <1.005, urine output >/= 4ml/kg/hr
-management: vasopressin or DDAVP, fluid replacement
-causes: CNS injury or infection, hypothalamus or pituitary disorders, tumor resection, renal defects

3

Cerebral salt wasting

-anti natuiretic hormone excess results in sodium excretion into urine and diuresis with resulting hyponatremia and euvolemia or hypovolemia
-lab findings: serum Na <135, serum osmo <280, urine Na >30, urine osmo >200, urine spec gravity >1.010, urine output 2-3ml/kg/hr
-management: treat underlying problem, replace sodium slowly, likely hypovolemic --> maintain fluid intake
-causes: CNS injury or infection, endocrine disturbance, DKA, chronic lung disease, cardiac disease

4

Diabetic ketoacidosis

-insulin deficiency where starvation state causes hyperglycemia and ketone formation with lactic acidosis from decreased tissue perfusion --> results in metabolic acidosis
-diagnosis: pH < 7.3, HCO3 <15
-management: NS bolus 20ml/kg, insulin drip 0.05-0.1u/kg/hr, add glucose when serum glucose is 250-300 or dropping faster than 100/hr, replace potassium and phosphorus, convert to subcutaneous when pH and HCO3 are normalized

5

Congenital adrenal hyperplasia

-newborn with ambiguous genitalia, salt wasting and shock
-classic triad: hyperkalemia, hyponatremia and dehydration
-management with fluids and electrolytes, glucocorticoids and hydrocortisone