Sandbox:Vindhya: Difference between revisions

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Disease
Disease
!Causes
!Causes
|Features and diagnosis
|Symptoms
|Diagnosis and treatment
|- Diagnostic criteria of SIADH include:
|- Diagnostic criteria of SIADH include:


|SIADH
|SIADH
|SIADH is a syndrome characterized by excessive release of [[Vasopressin|antidiuretic hormone]] (ADH or vasopressin) from the [[posterior pituitary]] gland or another source. The result is [[hyponatremia]], and sometimes fluid overload.
|SIADH is a syndrome characterized by excessive release of [[Vasopressin|antidiuretic hormone]] (ADH or vasopressin) from the [[posterior pituitary]] gland or another source. The result is [[hyponatremia]], and sometimes fluid overload.
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|Hyponatremia <135 mmol/l
|Hyponatremia <135 mmol/l


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|Cerebral salt wasting
|Cerebral salt wasting
| Cerebral salt wasting is defined as the renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume.
| Cerebral salt wasting is defined as the renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume.
|
|The patient is hypovolemic and hyponatremic.
|The patient is hypovolemic and hyponatremic.
Treatment is with adequate hydration and sodium replacement.
Treatment is with adequate hydration and sodium replacement.
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Secondary adrenal insufficiency refers to decreased adrenocorticotropic hormone (ACTH) stimulation of the adrenal cortex and therefore does not affect aldosterone levels. Traumatic brain injury (TBI) and panhypopituitarism are common causes.  
Secondary adrenal insufficiency refers to decreased adrenocorticotropic hormone (ACTH) stimulation of the adrenal cortex and therefore does not affect aldosterone levels. Traumatic brain injury (TBI) and panhypopituitarism are common causes.  
Tertiary adrenal insufficiency refers to decreased hypothalamic stimulation of the pituitary to secrete ACTH. Exogenous steroid administration is the most common cause of tertiary adrenal insufficiency.  
Tertiary adrenal insufficiency refers to decreased hypothalamic stimulation of the pituitary to secrete ACTH. Exogenous steroid administration is the most common cause of tertiary adrenal insufficiency.  
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*Idiopathic
*Idiopathic
*congenital  
*congenital  
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*post radiation
*post radiation
*Infiltrative e.g., amyloid
*Infiltrative e.g., amyloid
 
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*Traumatic brain injury
*Traumatic brain injury
*Psychiatric disorders such as schizophrenia
*Psychiatric disorders such as schizophrenia
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Revision as of 18:16, 3 August 2017

Disease

Causes Symptoms Diagnosis and treatment
SIADH SIADH is a syndrome characterized by excessive release of antidiuretic hormone (ADH or vasopressin) from the posterior pituitary gland or another source. The result is hyponatremia, and sometimes fluid overload. Hyponatremia <135 mmol/l

Decreased effective serum osmolality<275mosm

Urine sodium concentration>40mmol/litre

Plasma uric acid <200;FeUrate>12%

Absence of edematous disease like cardiac failure, liver cirrhosis, nephrotic syndrome.

normal adrenal and thyroid function

Cerebral salt wasting Cerebral salt wasting is defined as the renal loss of sodium during intracranial disease leading to hyponatremia and a decrease in extracellular fluid volume. The patient is hypovolemic and hyponatremic.

Treatment is with adequate hydration and sodium replacement.

Adrenal insufficiency Adrenal insufficiency ranges from mild nonspecific symptoms to life-threatening shock condition. An important distinction in these patients is the presence of mineralocorticoid deficiency. Those with secondary or tertiary adrenal insufficiency will typically have preserved mineralocorticoid function due to the separate feedback systems.

Adrenal insufficency can be primary, secondary or tertiary. Common causes of primary adrenal insufficiency:

  • Autoimmune
  • Iatrogenic
  • Drugs
  • Others- adrenal hemorrhage, cancer, infection.
  • congenital.

Secondary adrenal insufficiency refers to decreased adrenocorticotropic hormone (ACTH) stimulation of the adrenal cortex and therefore does not affect aldosterone levels. Traumatic brain injury (TBI) and panhypopituitarism are common causes. Tertiary adrenal insufficiency refers to decreased hypothalamic stimulation of the pituitary to secrete ACTH. Exogenous steroid administration is the most common cause of tertiary adrenal insufficiency.

Hypopituitarism: Hypopituitarism is defined as the partial or complete loss of anterior pituitary function that can result from acquired or congenital causes.

Etiology is as follows:

  • Pituitary tumors
  • Sellar tumors
  • Head trauma
  • Infection
  • empty sella
  • infiltration
  • Idiopathic
  • congenital
Hypothyroidism Hypofunctioning of the thyroid gland due to multifactorial etiology ranging from congenital to autoimmune causes described below:
  • Congenital
  • Autoimmune
  • Drugs
  • Post surgery
  • post radiation
  • Infiltrative e.g., amyloid
Psychogenic polydipsia Also called as primary polydipsia is charactreized by polyuria and polydipsia. Causes could be:
  • Defect in the hypothalamus
  • Adverse effect of a medication
  • Traumatic brain injury
  • Psychiatric disorders such as schizophrenia