Patho
What does SIADH stand for?
Syndrome of inappropriate anti-diuretic hormone
What do you expect your serum sodium level to be in a patient that suffers from SIADH?
Is SIADH a primary disease?
No it is a secondary disease
What is the best therapy to do for SIADH?
What stores and releases ADH?
Posterior Pituitary Gland
True or False. The body still releases normal levels of ADH in SIADH
True
What causes the sticky thick urine in SIADH?
ADH causes you to reabsorb water and therefore you lose your salt
What is the best treatment for SIADH?
Treatment of the underlying cause
Why did our patient receive chemotherapy and radiation?
To treat underlying illness of small cell carcinoma of lung
What does ADH do in the body?
ADH decreases urine output by reabsorbing water in the kidneys
What is the main cancer that causes SIADH?
Small cell carcinoma of the lung
What is the most important early sign of SIADH?
Headaches!
Why would you restrict fluids in a patient with SIADH?
Patient already has fluid overload
What does furosemide do?
It is a loop diuretic for fluid overload
What causes the normal release of ADH in the body
Dehydration
What would you expect the specific gravity of urine in a patient suffering from SIADH to look like?
High
What causes seizures and coma in severe cases of SIADH
Fluid shift from ICF causes cerebral edema which causes intracranial pressure
Why would someone with SIADH need to have a heart monitor?
Hyponatremia caused by SIADH affects the heart and it's rhythm
Why would our patient raise his legs in bed?
To help treat edema in his lower limbs
What part of the kidneys does ADH affect?
Distal convoluted tubules or the collecting duct
What type of cancer cells cause SIADH in small cell carcinoma?
Neuroendocrine cells
What sign of SIADH is described as periods of hyperpnea and hypopnea followed by a period of apnea
Cheyne-Stokes Respirations
Why would you only give NaCL normal saline in extreme circumstances?
Why does our patient still experience thirst when he is reabsorbing too much water?
When ADH is released your body tells you to drink more. So even if your osmotic threshold is low your body will stimulate the thirst mechanism due to the release of ADH
Osmoreceptors of the blood and Baroreceptors in the heart