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Endocrine System

Gesundheit & Medizin

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Discussion #1 Diabetes Insipidus Antidiuretic Hormone (ADH) is synthesized in the hypothalamus and secreted by the posterior pituitary. Its role plays part in the body’s osmotic balance, blood pressure regulation, and kidney function. ADH affects the ability of the kidney to reabsorb water and in addition induces expression of water transport proteins in the late distal tubule and collecting duct to increase water reabsorption (Cuzzo & Lappin, 2018). Diabetes Insipidus occurs with a decreased or absent ADH causing symptoms such as polyuria and polydipsia. Three types of diabetes insipidus include: neurogenic, nephrogenic, and polydipsic (McCance & Huether, 2014). Neurogenic DI is the most commen and caused by insufficient amounts of ADH. Damage to the pituitary gland or hypothalamus from surgery, a tumor, a head injury or an illness can cause neurogenic diabetes insipidus by affecting the usual production, storage, and release of ADH (McCance & Huether, 2014). Nephrogenic DI is often idiopathic. It occurs when there's a defect in the kidney tubules. The defect may be due to an inherited disorder or a chronic kidney disorder (McCance & Huether, 2014). Polydipsic DI can cause production of large amounts of diluted urine. The underlying cause is drinking an excessive amount of fluids that is caused by damage to the thirst-regulating mechanism in the hypothalamus. The condition has also been linked to mental illness (McCance & Huether, 2014). “DI must be distinguished from other polyuric states, including diabetes mellitus. The basic criteria for the diagnosis of DI include polyuria, polydipsia, low urine specific gravity (<1.010), low urine osmolality (<200 mOsm/kg), hypernatremia, high serum osmolality (300 mOsm or more depending on adequate water intake), and continued diuresis despite a serum sodium level of 145 mEq/L or greater” (McCance & Huether, p. 720). Treatment for neurogenic diabetes insipidus includes increasing water intake or desmopressin (DDAVP).This medication replaces the missing anti-diuretic hormone and decreases urination. Treatment for nephrogenic diabetes insipidus includes stopping initial cause if medication induced or treatment with thiazide diuretics. Treatment for polydipsic diabetes insipidus includes decreasing fluid intake (McCance & Huether, 2014). A red flag symptom requiring urgent treatment of diabetes insipidus would include passing large amounts of dilute urine. This can cause severe electrolyte disturbances and intravascular depletion leading to shock (McCance & Huether, 2014). Discussion #2 Diabetes insipidus (DI) is a rare condition that occurs when your kidneys are not able to conserve water. DI is not related to diabetes mellitus, which is often referred to simply as diabetes. That means you can have DI without having diabetes. In fact, the condition can occur in anyone. DI results in extreme thirst and frequent urination of dilute and odorless urine. There are several types of DI, and they can often .

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These are simplified slides discussing the regulation of cardiac output and venous return. Learning objectives: 1. Comprehend the determinants of cardiac output and factors affecting cardiac output 2. Comprehend the factors affecting stroke volume and heart rate and total peripheral resistance 3. Identify the factors regulating venous return 4. Discuss the causes of high and low output cardiac failure 5. Enlist the functions of veins and recognise the significance of venous reservoirs Study Resources: 1. Chapter 20, Guyton and Hall Textbook of Medical Physiology, 14th edition 2. Chapter 30 and 32, Ganong’s Review of Medical Physiology, 26th edition 3. Chapter 10, Human Physiology by Lauralee Sherwood, 9th edition 4. Physiology, Cardiac Output - StatPearls https://www.ncbi.nlm.nih.gov/books/NBK470455/

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