Arginine Vasopressin (AVP) Differential Diagnoses

by Carlo Raj, MD

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    Let’s take a look at important arginine vasopressin differential diagnoses. Once you’ve understood all of different topics that we covered up above, you go to this table and you take a look at the labs so that you’re able to clearly and quickly differentiate one pathology from the other. And not all these are pathology. Some of these are pathophysiologic point. For example, water deprivation. Close your eyes. The water deprivation, what’s your plasma osmolarity? Increased. What’s your urine osmolarity? Increased. Water deprivation. Osmoreceptors of hypothalamus. You tell me. Stimulated, ADH comes out. Therefore, you can expect your serum ADH to be increased. First column. You tell me about plasma urine osmolality. Done. Flow rate – obviously, low because you’re reabsorbing water. Stop. Concept. Clearance means what? It doesn’t mean filtration, doesn’t mean reabsorption, it does not mean excretion. It means what you’ve actually cleared out of the body. Clearance, in other words, excretion. Of what? Free water. What does free water mean to you? It’s water that is not obligated to sodium. It’s not obligated water, it’s free water. Next. That’s a concept. If there’s ADH, what you’re doing to free water? You’re reabsorbing it. So, therefore, how much free water are you clearing? Negative. SIADH. Give me some reasons. Oh, the triphasic, first and second triphasic. Neurosurgery, transsphenoidal. You might be releasing too much ADH. Maybe there’s lung disease. What kind? Maybe pneumonia, maybe there’s thoracic surgery or maybe lung cancer such as small-cell. Whatever the reason, increased serum ADH abundantly. We know about plasma and urine and we know about flow rate and there’s your clearance of free water. Then we have water drinking. If you’re drinking water or let’s say that you have primary polydipsia and you’re drinking water too much, excessively. Here, things are different,...

    About the Lecture

    The lecture Arginine Vasopressin (AVP) Differential Diagnoses by Carlo Raj, MD is from the course Pituitary Gland Disorders.

    Included Quiz Questions

    1. Nephrogenic diabetes insipidus
    2. SIADH
    3. Central diabetes insipidus
    4. High water intake
    5. Water deprivation
    1. Nephrogenic diabetes insipidus
    2. Water deprivation
    3. High water intake
    4. Central diabetes insipidus
    5. SIADH
    1. Nephrotic syndrome
    2. SIADH
    3. Addison's disease
    4. Hypothyroidism
    5. Paraneoplastic syndrome
    1. Urine osmolarity decreases
    2. Urine osmolarity increases
    3. Clearance of water decreases
    4. Plasma osmolarity increases
    5. Plasma osmolarity decreases
    1. Results in increased cAMP in target cells
    2. Synthesized in paraventricular nuclei of the hypothalamus
    3. Stored in posterior pituitary
    4. Stimulates Gq receptors
    5. Induces a positive feedback response
    1. Tocolytic and oxytocin receptor antagonist
    2. Synthetic form of oxytocin
    3. Promoter of breast myoepithelial contractions to promote lactation
    4. Enhance positive feedback loop initiated by oxytocin
    5. Enhance uterine contractions to promote labor

    Author of lecture Arginine Vasopressin (AVP) Differential Diagnoses

     Carlo Raj, MD

    Carlo Raj, MD

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