Exam3Lecture4

Patients undergo extreme loss of caution water water

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Unformatted text preview: show a decrease in urine production » Caution - with insipidus patients undergo extreme loss of Caution water water – Urine concentration - monitored – Serum ADH levels - monitored Alterations Hypothalamic-Pituitary System Alterations Diabetes insipidus Water restriction test results Patients with Neurogenic D.I. Urine Concentration? Urine Remains Low (will not concentrate urine) Remains ADH levels? ADH Low (Pituitary can not secrete ADH) secrete Alterations Hypothalamic-Pituitary System Alterations Diabetes insipidus Water restriction test results Patients with Nephrogenic D.I. Urine concenrtration? Urine Remains low (will not concentrate urine) Remains ADH levels? ADH Increases (Pituitary secrets ADH secrets Alterations Hypothalamic-Pituitary System Alterations Diabetes insipidus Treatment – Neurogenic insipidus - ADH replacement if.. » With dilute urine (100 mOsm/kg post water reduction test) » With excessive urine production (9 L /day) Alterations Hypothalamic-Pituitary System Alterations Diabetes insipidus ADH replacement – Synthetic vasopressin = “desmopressin” (=DDAVP) – Chlorpropamide » Enhances action of endogenous ADH Patients with some ADH present Alterations Hypothalamic-Pituitary System Alterations Hypopituitarism Possible causes – Pituitary infarction (loss of circulation) » Postpartum pituitary necrosis » Shock » Pituitary apoplexy (tumor necrosis) » Sickle anemia – Head trauma – Infections (meningitis) Alterations Hypothalamic-Pituitary System Alterations Hypopituitarism Pathophysiology – Pituitary is highly vascularized - implications » Vulnerable to ischemia and infarction – Illustrated in “Sheehan syndrome” » Postpartum hypopituitarism Alterations Hypothalamic-Pituitary System Alterations Hypopituitarism - Sheehan Syndrome Hypopituitarism Sheehan During pregnancy – Increases in vasculature of the pituitary – Increases in pituitary size – Blood supply to the pituitary -...
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This note was uploaded on 04/02/2013 for the course BIO 205 taught by Professor Dr.cady during the Spring '11 term at Bradley.

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