SlideShare ist ein Scribd-Unternehmen logo
1 von 52
SIADH SYNDROME OF INAPPROPRIATE SECRETION OF ANTI DIURETIC HORMONE 22.12.10
Outline Of The Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object]
Prevalance of hyponatremia ,[object Object],[object Object],Sajadieh A.AJEM 2009  122  679–686  . Gankam Kengne F.QJOM 2008  101  583–588
[object Object],[object Object],Zilberberg MD  BMC Pulmonary Medicine  2008  8  16. Sherlock M  Endocrinology  2006  64  250–254
ADH:  AntiDiuretic Hormone ,[object Object],[object Object],[object Object]
 
Function of ADH  ,[object Object],[object Object],[object Object],[object Object]
[object Object]
Syndrome of Inappropriate    AntiDiuretic Hormone ,[object Object],[object Object]
…… .SIADH……. ,[object Object],[object Object],[object Object]
Cardiac failure or cirrhosis on diuretic therapy   Cirrhosis Cardiac failure Nephrotic syndrome Peripheral oedema Ascites Raised JVP Pulmonary oedema Underlying illness Hypervolaemic   SIADH ACTH deficiency Hypothyroidism SIADH with ongoing fluid restriction Primary polydipsia Inappropriate fluid replacement Underlying illness   Euvolaemic Diuretics Addison's disease Cerebral salt wasting Salt wasting nephropathy GI losses, Mucosal losses, Pancreatitis Sodium depletion post diuretics Dry mucous membranes, Decreased turgor, Tachycardia, Hypotension (orthostatic), Raised urea, rennin Hypovolaemic   Urinary Na+>40  mmol/l  Urinary Na+<20  mmol/l  Clinical signs
[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object],[object Object],M J Hannon. European Journal of Endocrinology,2010. Vol 162
Causes of SIADH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of SIADH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Classification of SIADH  ,[object Object],[object Object],Zerbe R  Annual Review of Medicine  1980  31  315–327
Type A SIADH  ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Type B SIADH ,[object Object],[object Object],[object Object],[object Object]
Type C SIADH ,[object Object],[object Object],[object Object]
Type D SIADH ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Copyright ©2010 European Society of Endocrinology Eur J Endocrinol. 2010 Jun;162(Suppl1):S5-S12 Figure 1 Summary of the four different patterns of AVP secretion in SIADH
CLINICAL FEATURES ,[object Object],[object Object],[object Object]
CLINICAL FEATURES ,[object Object],[object Object],[object Object]
Laboratory Evaluation  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Table 1  Diagnostic criteria for SIADH  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TREATMENT ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Isotonic saline ,[object Object],[object Object],[object Object]
Hypertonic saline ,[object Object],[object Object]
The Adrogué–Madias formula ,[object Object],[object Object]
Simple Rule Of Thumb ,[object Object],[object Object]
Demeclocycline ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Lithium ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Urea ,[object Object],[object Object],[object Object],[object Object],[object Object]
Extracorporeal treatments ,[object Object],[object Object],[object Object]
The vaptans  ,[object Object],[object Object],[object Object],[object Object],[object Object]
V2 receptor antagonists in the treatment of SIADH. ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
How should treatment be monitored?   ,[object Object],[object Object],[object Object]
SUMMARY ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
THANK YOU

Weitere ähnliche Inhalte

Was ist angesagt?

Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
Abhay Mange
 
Complications of hemodialysis
Complications of hemodialysisComplications of hemodialysis
Complications of hemodialysis
Reynel Dan
 
Eisenmenger syndrome
Eisenmenger syndromeEisenmenger syndrome
Eisenmenger syndrome
Fuad Farooq
 

Was ist angesagt? (20)

Myxedema coma
Myxedema comaMyxedema coma
Myxedema coma
 
Syndrome of inappropriate antidiuretic hormone secretion
Syndrome of inappropriate antidiuretic hormone secretionSyndrome of inappropriate antidiuretic hormone secretion
Syndrome of inappropriate antidiuretic hormone secretion
 
Acute kidney injury
Acute kidney injuryAcute kidney injury
Acute kidney injury
 
Hyperkalemia 160108171542
Hyperkalemia 160108171542Hyperkalemia 160108171542
Hyperkalemia 160108171542
 
Pulmonary hypertension
Pulmonary hypertensionPulmonary hypertension
Pulmonary hypertension
 
Hyperaldosteronism
HyperaldosteronismHyperaldosteronism
Hyperaldosteronism
 
Complications of hemodialysis
Complications of hemodialysisComplications of hemodialysis
Complications of hemodialysis
 
Hyperkalemia and its management
Hyperkalemia and its managementHyperkalemia and its management
Hyperkalemia and its management
 
Pancytopenia
PancytopeniaPancytopenia
Pancytopenia
 
Hyponatremia
HyponatremiaHyponatremia
Hyponatremia
 
Conn’s syndrome
Conn’s syndromeConn’s syndrome
Conn’s syndrome
 
chronic liver disease (CLD)
chronic liver disease (CLD)chronic liver disease (CLD)
chronic liver disease (CLD)
 
Eisenmenger syndrome
Eisenmenger syndromeEisenmenger syndrome
Eisenmenger syndrome
 
Hypokalemia
HypokalemiaHypokalemia
Hypokalemia
 
Renal replacement therapy
Renal replacement therapyRenal replacement therapy
Renal replacement therapy
 
Fulminant hepatic failure (fhf)
Fulminant hepatic failure (fhf)Fulminant hepatic failure (fhf)
Fulminant hepatic failure (fhf)
 
Acute Kidney Injury
Acute Kidney InjuryAcute Kidney Injury
Acute Kidney Injury
 
Syndrome of inappropriate anti diuretic hormone secretion (siadh)
Syndrome of inappropriate anti diuretic hormone secretion (siadh)Syndrome of inappropriate anti diuretic hormone secretion (siadh)
Syndrome of inappropriate anti diuretic hormone secretion (siadh)
 
secondary hypertension
secondary hypertensionsecondary hypertension
secondary hypertension
 
ALDOSTERONISM
ALDOSTERONISM ALDOSTERONISM
ALDOSTERONISM
 

Andere mochten auch

Diabetes insipidus
Diabetes insipidusDiabetes insipidus
Diabetes insipidus
bmartin53
 
water electrolyte
water electrolytewater electrolyte
water electrolyte
Pacman28
 
Posterior Pituitary Gland quiz bee
Posterior Pituitary Gland quiz beePosterior Pituitary Gland quiz bee
Posterior Pituitary Gland quiz bee
shenell delfin
 

Andere mochten auch (20)

Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)
Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)
Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)
 
Concept Map of Syndrome of Inappropriate (ly high) Anti-Diuretic Hormone (SIADH)
Concept Map of Syndrome of Inappropriate (ly high) Anti-Diuretic Hormone (SIADH)Concept Map of Syndrome of Inappropriate (ly high) Anti-Diuretic Hormone (SIADH)
Concept Map of Syndrome of Inappropriate (ly high) Anti-Diuretic Hormone (SIADH)
 
Di, siadh and cerebral salt wasting syndrome
Di, siadh and cerebral salt wasting syndromeDi, siadh and cerebral salt wasting syndrome
Di, siadh and cerebral salt wasting syndrome
 
SIADH
SIADHSIADH
SIADH
 
Diabetes insipidus
Diabetes insipidusDiabetes insipidus
Diabetes insipidus
 
Diabetes insipidus
Diabetes insipidusDiabetes insipidus
Diabetes insipidus
 
Diabetes insipidus
Diabetes insipidusDiabetes insipidus
Diabetes insipidus
 
Approach to a patient with jaundice
Approach to a patient with jaundiceApproach to a patient with jaundice
Approach to a patient with jaundice
 
Hyponatraemia - Case Report
Hyponatraemia - Case ReportHyponatraemia - Case Report
Hyponatraemia - Case Report
 
Cerebral salt wasting and siadh
Cerebral salt wasting and siadhCerebral salt wasting and siadh
Cerebral salt wasting and siadh
 
Beta blockers in brain injuries
Beta blockers in brain injuriesBeta blockers in brain injuries
Beta blockers in brain injuries
 
Hiperparathyroid and Kidney Stone
Hiperparathyroid and Kidney StoneHiperparathyroid and Kidney Stone
Hiperparathyroid and Kidney Stone
 
Cerebral salt wasting syndrome
Cerebral salt wasting syndromeCerebral salt wasting syndrome
Cerebral salt wasting syndrome
 
20 sep 2010 siadh
20 sep 2010 siadh20 sep 2010 siadh
20 sep 2010 siadh
 
Diabetes insipidus and neurological disorders
Diabetes insipidus and neurological disordersDiabetes insipidus and neurological disorders
Diabetes insipidus and neurological disorders
 
Di, siadh and csws
Di, siadh and cswsDi, siadh and csws
Di, siadh and csws
 
Hypernatraemia
HypernatraemiaHypernatraemia
Hypernatraemia
 
Febrile neutropenia
Febrile neutropeniaFebrile neutropenia
Febrile neutropenia
 
water electrolyte
water electrolytewater electrolyte
water electrolyte
 
Posterior Pituitary Gland quiz bee
Posterior Pituitary Gland quiz beePosterior Pituitary Gland quiz bee
Posterior Pituitary Gland quiz bee
 

Ähnlich wie SIADH

shock types management
shock types managementshock types management
shock types management
drsvignesh78
 
Acute Poststreptococcal Glomerulonephritis
Acute Poststreptococcal GlomerulonephritisAcute Poststreptococcal Glomerulonephritis
Acute Poststreptococcal Glomerulonephritis
Hakimah Suhaimi
 

Ähnlich wie SIADH (20)

Haemoglobinopathies thalassemia, prophyrias and sickle cell disease-
Haemoglobinopathies  thalassemia, prophyrias and sickle cell disease-Haemoglobinopathies  thalassemia, prophyrias and sickle cell disease-
Haemoglobinopathies thalassemia, prophyrias and sickle cell disease-
 
Hyper function of adrenal
Hyper function of adrenalHyper function of adrenal
Hyper function of adrenal
 
uproach to anemia in ICU
uproach to anemia in ICUuproach to anemia in ICU
uproach to anemia in ICU
 
Complications of Haemodialysis
Complications of HaemodialysisComplications of Haemodialysis
Complications of Haemodialysis
 
hyponatremiaandhypernatremia-160310202741.pdf
hyponatremiaandhypernatremia-160310202741.pdfhyponatremiaandhypernatremia-160310202741.pdf
hyponatremiaandhypernatremia-160310202741.pdf
 
Hyponatremia and hypernatremia
Hyponatremia and hypernatremiaHyponatremia and hypernatremia
Hyponatremia and hypernatremia
 
Hemodialysis catastrope
Hemodialysis catastropeHemodialysis catastrope
Hemodialysis catastrope
 
Cirrosis of liver and its complication and traetment of hep b and c
Cirrosis of liver and its complication and traetment of hep b and cCirrosis of liver and its complication and traetment of hep b and c
Cirrosis of liver and its complication and traetment of hep b and c
 
hyponatremia final.pptx
hyponatremia final.pptxhyponatremia final.pptx
hyponatremia final.pptx
 
MYXOEDEMA COMA
MYXOEDEMA COMAMYXOEDEMA COMA
MYXOEDEMA COMA
 
Endocrine hypertension
Endocrine hypertensionEndocrine hypertension
Endocrine hypertension
 
Hyponatremia 040113.ppt
Hyponatremia 040113.pptHyponatremia 040113.ppt
Hyponatremia 040113.ppt
 
Hyponatremia 040113 (1)
Hyponatremia 040113 (1)Hyponatremia 040113 (1)
Hyponatremia 040113 (1)
 
shock types management
shock types managementshock types management
shock types management
 
Hyponatremia and hypernatremia 2015
Hyponatremia and hypernatremia  2015Hyponatremia and hypernatremia  2015
Hyponatremia and hypernatremia 2015
 
Hyponatremia and hypernatremia 2015
Hyponatremia and hypernatremia  2015Hyponatremia and hypernatremia  2015
Hyponatremia and hypernatremia 2015
 
Acute Poststreptococcal Glomerulonephritis
Acute Poststreptococcal GlomerulonephritisAcute Poststreptococcal Glomerulonephritis
Acute Poststreptococcal Glomerulonephritis
 
Approach to hyponatremia
Approach to hyponatremiaApproach to hyponatremia
Approach to hyponatremia
 
Diabetes insipidus by lahari
Diabetes insipidus by lahariDiabetes insipidus by lahari
Diabetes insipidus by lahari
 
Sickle cell disease
Sickle cell diseaseSickle cell disease
Sickle cell disease
 

Mehr von Vishal Golay

Acid base and control for the dialysis technician
Acid base and control for the dialysis technicianAcid base and control for the dialysis technician
Acid base and control for the dialysis technician
Vishal Golay
 
Deceased donor kidney transplantation-Recipient care.
Deceased donor kidney transplantation-Recipient care.Deceased donor kidney transplantation-Recipient care.
Deceased donor kidney transplantation-Recipient care.
Vishal Golay
 
SLE: present guidelines and consensus
SLE: present guidelines and consensusSLE: present guidelines and consensus
SLE: present guidelines and consensus
Vishal Golay
 
Basics of peritoneal dialysis
Basics of peritoneal dialysisBasics of peritoneal dialysis
Basics of peritoneal dialysis
Vishal Golay
 
Bk virus nephropathy
Bk virus nephropathyBk virus nephropathy
Bk virus nephropathy
Vishal Golay
 
Year in review 2011-Nature reviews
Year in review 2011-Nature reviewsYear in review 2011-Nature reviews
Year in review 2011-Nature reviews
Vishal Golay
 
Membranous nephropathy
Membranous nephropathyMembranous nephropathy
Membranous nephropathy
Vishal Golay
 
Contrast induced acute kidney injury
Contrast induced acute kidney injuryContrast induced acute kidney injury
Contrast induced acute kidney injury
Vishal Golay
 
Interpretation of the Arterial Blood Gas analysis
Interpretation of the Arterial Blood Gas analysisInterpretation of the Arterial Blood Gas analysis
Interpretation of the Arterial Blood Gas analysis
Vishal Golay
 
PRCA post renal transplant-a case and review
PRCA post renal transplant-a case and reviewPRCA post renal transplant-a case and review
PRCA post renal transplant-a case and review
Vishal Golay
 
Transplantation in sensitized patients(seminar)
Transplantation in sensitized patients(seminar)Transplantation in sensitized patients(seminar)
Transplantation in sensitized patients(seminar)
Vishal Golay
 
Anemia in Chronic Kidney DIsease
Anemia in Chronic Kidney DIseaseAnemia in Chronic Kidney DIsease
Anemia in Chronic Kidney DIsease
Vishal Golay
 

Mehr von Vishal Golay (20)

Acid base and control for the dialysis technician
Acid base and control for the dialysis technicianAcid base and control for the dialysis technician
Acid base and control for the dialysis technician
 
Deceased donor kidney transplantation-Recipient care.
Deceased donor kidney transplantation-Recipient care.Deceased donor kidney transplantation-Recipient care.
Deceased donor kidney transplantation-Recipient care.
 
Approach to deceased donor transplantation
Approach to deceased donor transplantationApproach to deceased donor transplantation
Approach to deceased donor transplantation
 
SLE: present guidelines and consensus
SLE: present guidelines and consensusSLE: present guidelines and consensus
SLE: present guidelines and consensus
 
Basics of peritoneal dialysis
Basics of peritoneal dialysisBasics of peritoneal dialysis
Basics of peritoneal dialysis
 
Bk virus nephropathy
Bk virus nephropathyBk virus nephropathy
Bk virus nephropathy
 
Year in review 2011-Nature reviews
Year in review 2011-Nature reviewsYear in review 2011-Nature reviews
Year in review 2011-Nature reviews
 
Membranous nephropathy
Membranous nephropathyMembranous nephropathy
Membranous nephropathy
 
Contrast induced acute kidney injury
Contrast induced acute kidney injuryContrast induced acute kidney injury
Contrast induced acute kidney injury
 
Water treatment and quality control of dialysate.
Water treatment and quality control of dialysate.Water treatment and quality control of dialysate.
Water treatment and quality control of dialysate.
 
Interpretation of the Arterial Blood Gas analysis
Interpretation of the Arterial Blood Gas analysisInterpretation of the Arterial Blood Gas analysis
Interpretation of the Arterial Blood Gas analysis
 
PRCA post renal transplant-a case and review
PRCA post renal transplant-a case and reviewPRCA post renal transplant-a case and review
PRCA post renal transplant-a case and review
 
Diuretics in CKD
Diuretics in CKDDiuretics in CKD
Diuretics in CKD
 
Transplantation in sensitized patients(seminar)
Transplantation in sensitized patients(seminar)Transplantation in sensitized patients(seminar)
Transplantation in sensitized patients(seminar)
 
Anemia in Chronic Kidney DIsease
Anemia in Chronic Kidney DIseaseAnemia in Chronic Kidney DIsease
Anemia in Chronic Kidney DIsease
 
Nephrocalcinosis
NephrocalcinosisNephrocalcinosis
Nephrocalcinosis
 
Seminar on renal tuberculosis
Seminar on renal tuberculosisSeminar on renal tuberculosis
Seminar on renal tuberculosis
 
Induction agents in renal transplantation
Induction agents in renal transplantationInduction agents in renal transplantation
Induction agents in renal transplantation
 
Dialysis statistics(Jan-April'11)
Dialysis statistics(Jan-April'11)Dialysis statistics(Jan-April'11)
Dialysis statistics(Jan-April'11)
 
Renal biopsy seminar
Renal biopsy seminarRenal biopsy seminar
Renal biopsy seminar
 

Kürzlich hochgeladen

Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Sheetaleventcompany
 
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Sheetaleventcompany
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
Sheetaleventcompany
 
Ahmedabad Call Girls Book Now 8980367676 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 8980367676 Top Class Ahmedabad Escort Service A...Ahmedabad Call Girls Book Now 8980367676 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 8980367676 Top Class Ahmedabad Escort Service A...
Genuine Call Girls
 
Kolkata Call Girls Service ❤️🍑 9xx000xx09 👄🫦 Independent Escort Service Kolka...
Kolkata Call Girls Service ❤️🍑 9xx000xx09 👄🫦 Independent Escort Service Kolka...Kolkata Call Girls Service ❤️🍑 9xx000xx09 👄🫦 Independent Escort Service Kolka...
Kolkata Call Girls Service ❤️🍑 9xx000xx09 👄🫦 Independent Escort Service Kolka...
Sheetaleventcompany
 
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Sheetaleventcompany
 

Kürzlich hochgeladen (20)

7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
7 steps How to prevent Thalassemia : Dr Sharda Jain & Vandana Gupta
 
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
Premium Call Girls Dehradun {8854095900} ❤️VVIP ANJU Call Girls in Dehradun U...
 
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
Gastric Cancer: Сlinical Implementation of Artificial Intelligence, Synergeti...
 
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
Call Girl In Chandigarh 📞9809698092📞 Just📲 Call Inaaya Chandigarh Call Girls ...
 
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
Call Girls Bangalore - 450+ Call Girl Cash Payment 💯Call Us 🔝 6378878445 🔝 💃 ...
 
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
Chandigarh Call Girls Service ❤️🍑 9809698092 👄🫦Independent Escort Service Cha...
 
Low Cost Call Girls Bangalore {9179660964} ❤️VVIP NISHA Call Girls in Bangalo...
Low Cost Call Girls Bangalore {9179660964} ❤️VVIP NISHA Call Girls in Bangalo...Low Cost Call Girls Bangalore {9179660964} ❤️VVIP NISHA Call Girls in Bangalo...
Low Cost Call Girls Bangalore {9179660964} ❤️VVIP NISHA Call Girls in Bangalo...
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Kolkata Call Girls Naktala 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
Kolkata Call Girls Naktala  💯Call Us 🔝 8005736733 🔝 💃  Top Class Call Girl Se...Kolkata Call Girls Naktala  💯Call Us 🔝 8005736733 🔝 💃  Top Class Call Girl Se...
Kolkata Call Girls Naktala 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...
 
Circulatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanismsCirculatory Shock, types and stages, compensatory mechanisms
Circulatory Shock, types and stages, compensatory mechanisms
 
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
Call Girl In Indore 📞9235973566📞 Just📲 Call Inaaya Indore Call Girls Service ...
 
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
💚Call Girls In Amritsar 💯Anvi 📲🔝8725944379🔝Amritsar Call Girl No💰Advance Cash...
 
Ahmedabad Call Girls Book Now 8980367676 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 8980367676 Top Class Ahmedabad Escort Service A...Ahmedabad Call Girls Book Now 8980367676 Top Class Ahmedabad Escort Service A...
Ahmedabad Call Girls Book Now 8980367676 Top Class Ahmedabad Escort Service A...
 
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service AvailableCall Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
Call Girls Mussoorie Just Call 8854095900 Top Class Call Girl Service Available
 
Cardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their RegulationCardiac Output, Venous Return, and Their Regulation
Cardiac Output, Venous Return, and Their Regulation
 
Kolkata Call Girls Service ❤️🍑 9xx000xx09 👄🫦 Independent Escort Service Kolka...
Kolkata Call Girls Service ❤️🍑 9xx000xx09 👄🫦 Independent Escort Service Kolka...Kolkata Call Girls Service ❤️🍑 9xx000xx09 👄🫦 Independent Escort Service Kolka...
Kolkata Call Girls Service ❤️🍑 9xx000xx09 👄🫦 Independent Escort Service Kolka...
 
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
Call Girls in Lucknow Just Call 👉👉 8875999948 Top Class Call Girl Service Ava...
 
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
Dehradun Call Girls Service {8854095900} ❤️VVIP ROCKY Call Girl in Dehradun U...
 
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
💰Call Girl In Bangalore☎️63788-78445💰 Call Girl service in Bangalore☎️Bangalo...
 
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...
💰Call Girl In Bangalore☎️7304373326💰 Call Girl service in Bangalore☎️Bangalor...
 

SIADH

  • 1. SIADH SYNDROME OF INAPPROPRIATE SECRETION OF ANTI DIURETIC HORMONE 22.12.10
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.  
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. Cardiac failure or cirrhosis on diuretic therapy Cirrhosis Cardiac failure Nephrotic syndrome Peripheral oedema Ascites Raised JVP Pulmonary oedema Underlying illness Hypervolaemic SIADH ACTH deficiency Hypothyroidism SIADH with ongoing fluid restriction Primary polydipsia Inappropriate fluid replacement Underlying illness Euvolaemic Diuretics Addison's disease Cerebral salt wasting Salt wasting nephropathy GI losses, Mucosal losses, Pancreatitis Sodium depletion post diuretics Dry mucous membranes, Decreased turgor, Tachycardia, Hypotension (orthostatic), Raised urea, rennin Hypovolaemic Urinary Na+>40 mmol/l Urinary Na+<20 mmol/l Clinical signs
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27. Copyright ©2010 European Society of Endocrinology Eur J Endocrinol. 2010 Jun;162(Suppl1):S5-S12 Figure 1 Summary of the four different patterns of AVP secretion in SIADH
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.