Define SIAD and patient characteristics that may have contributed to development of
SIAD
Syndrome of inappropriate antidiuretic hormone (SIADH) secretion is characterized by
high levels of ADH in the absence of normal physiologic stimuli for its release(McCance &
Huether, 2019). Basically, it's the over secretion of ADH from the pituitary with an unknown
etiology. Our patient is at risk for acquiring SIADH as she is currently taking hypoglycemic
medications, antidepressants/antipsychotics,
and is elderly.
She is also a smoker, which
contributes to pulmonary disorders such as pneumonia, which is commonly associated with
SIADH.
McCance, K. L. & Huether, S. E. (2019).
Pathophysiology: The biologic basis for disease in
adults and children
(8th ed.). St. Louis, MO: Mosby/Elsevier.
Why the patient had the symptoms of hypocortisolism?
Hypocortisolism develops because of a primary inability of the adrenals to produce and
secrete the adrenocortical hormones (McCance & Huether, 2019). She has RA for 20 years plus
the extended use of prednisone; in addition, her symptoms maybe the result of stress placed upon
her by exacerbation of chronic RA. Classic symptoms of hypocortisolism begin with weakness
and fatigue, hyperpigmentation. Hormone and mineral corticoid deficiency symptoms include
hypotension, hypovolemia, dizziness, and hyperkalemia.
McCance, K. L. & Huether, S. E. (2019).
Pathophysiology: The biologic basis for disease in
adults and children
(8th ed.). St. Louis, MO: Mosby/Elsevier.
Role of parathyroid hormone in the development of primary hyperparathyroidism.
Hyperparathyroidism is characterized by greater than normal secretion of parathyroid
hormone (PTH) and hypercalcemia (McCance & Huether, 2019). Primary hyperparathyroidism
is caused by PTH secretion uncontrolled by the usual feedback mechanisms, resulting in
abnormally high levels of calcium in the blood, as indicated in our patients' labs. The high
calcium is cased by increase reabsorption, and Gi absorption of calcium yet fails to stop PTH
secretion.
McCance, K. L. & Huether, S. E. (2019).
Pathophysiology: The biologic basis for disease in
adults and children
(8th ed.). St. Louis, MO: Mosby/Elsevier.
Renal stone formation in a patient with hyperparathyroidism?
High levels of calcium in the bloodstream result in hypercalciuria, which also affects
renal function, causing metabolic acidosis, thus producing alkaline urine. PTH over secretion
contributes to phosphate extraction, inducing hypophosphatemia, and hyperphosphatemia, which
leads to the formation of renal calculi.
McCance, K. L. & Huether, S. E. (2019).
Pathophysiology: The biologic basis for disease in
adults and children
(8th ed.). St. Louis, MO: Mosby/Elsevier.
Hyperparathyroidism at risk for bone fracture?
Hyper osteoclastic and osteocytic activity results in an increase in the bone absorption of
calcium. This increased absorption of calcium weakens the bone, thus putting the patient more at
risk for done breakage and kyphosis.
