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Dysregulation of ADH

by Carlo Raj, MD
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    Let’s talk about dysregulation of ADH. ADH dysfunction, either deficiency central diabetes insipidus or receptor dysfunction for ADH. Nephrogenic diabetes insipidus is going to release… is going to result in what type of urine? Good, diluted urine. What’s your urine osmolality in these patients? Always decreased. What’s your plasma osmolality in these patients? Always increased. Who are my patients? Central or nephrogenic diabetes insipidus. In either case, you’ll have ADH dysfunction, it’s not working properly. Inability to concentrate the urine, what kind of urine again? The diluted urine. This patient is going to have polyuria, increased frequency. Right off the bag, this gives you a differential known as diabetes mellitus. How can you tell the difference? In diabetes insipidus, you wouldn’t have any hypoglycemia, your glucose cell were perfectly normal. However, polyuria is definitely present and polydipsia. Now, in psychogenic polydipsia... psychogenic polydipsia, what’s that mean to you? Have you heard of primary polydipsia? Psychogenic, meaning to say that the patient might be of schizophrenic type and therefore, may feel the need to be drinking water all the time. Why am I bringing that up? Because if you are drinking water all the time, let’s just say right now, you just take an entire litre of water and you just start guzzling it. This is a patient or you or me, it doesn’t matter, we’re going to produce diluted urine. What kind of urine do you have in diabetes insipidus? Diluted urine. So, what’s the difference? Take a look at the note. The note is, if your patient has primary polydipsia, psychogenic polydipsia, you’re drinking all that water as oppose to diabetes insipidus when you’re drinking water by itself, your plasma osmolality will be low. I began this section by asking you what’s my plasma osmolality in a patient with...

    About the Lecture

    The lecture Dysregulation of ADH by Carlo Raj, MD is from the course Pituitary Gland Disorders.


    Included Quiz Questions

    1. Hypoosmolar urine, hyperosmolar plasma
    2. Hyperosmolar urine, hyperosmolar plasma
    3. Hypoosmolar urine, hypoosmolar plasma
    4. Hyperosmolar urine, hypoosmolar plasma
    5. Hypoosmolar urine, neutral plasma
    1. Inability to concentrate urine
    2. Increased water intake
    3. Increased thirst response
    4. Increased blood glucose levels
    5. Decreased plasma osmolarity
    1. Dehydration
    2. Diabetes insipidus
    3. Psychogenic polydipsia
    4. Impaired renal water absorption
    5. Diabetes mellitus

    Author of lecture Dysregulation of ADH

     Carlo Raj, MD

    Carlo Raj, MD


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