This is Jeopardy!
This is the risk for a patient with diabetes insipidus
Hypovolemic shock
This is how you treat diabetes insipidus
DDAVP (ADH)
This is the treatment for a patient experiencing SIADH
Hypertonic saline
This is the risk for a patient experiencing SIADH
Seizures
This is the range of blood sugar in DKA
250 - 500
This is the range of blood sugar in HHNS
Over 600+
These are the causes of diabetes insipidus
Damage to brain (tumors, trauma, surgery)
HHNS (hyperglycemic hyperosmolar non-ketotic syndrome) is seen in this type of diabetes
Type 2
This is how you treat HHNS
H I E R
Hydration
Insulin
Electrolyte Replacement
DKA (diabetic ketoacidosis) is seen in this type of diabetes
Type 1
The 7 S’s of SIADH
1. STOPS urination (low urine output)
2. STICKY and thick urine (high sp. gr >1030)
3. SOAKED inside (low and liquidy labs)
A. Hypo-osmolality
B. Hyponatremia (below 135)
4. SODIUM low (headache early sign)
5. SEIZURES - Key words - headache/confusion
6. SEVERE HIGH blood pressure
7. STOP ALL FLUIDS - give salt + diuetics - no IV or drinking - IV 3% saline + eat salt
These are the features of DKA
“Think D K A A”
1. Dry and high sugar (250 - 500)
2. Ketones and Kussmal respirations (rapid, fruity breath)
3. Abdominal pain
4. Acidosis (metabolic) = pH 7.35 or less
5. Hyperkalemia
6. Polyuria
7. Tachycardia
These are the features of SIADH (syndrome of inappropriate antidiuretic hormone)
“Soaked inside”
1. High ADH/water intoxication
2. Low urine output, oliguria
3. Low Na (dilutional)
4. Low serum osmolality
5. Weight gain
The 7 D’s of diabetes insipidus
2. DILUTED urine - low sp. gr. (1.005)
3. DRY inside (high & dry labs)
A. Hyperosmolality
B. Hypernatremia (over 145)
4. DRINKING a lot - “thirsty”
5. DEHYDRATED - dry mucosa and skin
6. DECREASED blood pressure
7. DESMOPRESSIN (vasopressin) (ADH) to decrease urine output and to decrease sodium to less than 135
These are the causes of SIADH (think ”S”)
1. Small cell lung cancer
2. Severe brain trauma (trauma/surgery)
3. Sepsis infections of brain (meningitis)