DI vs SIADH | Endocrine System (Part 5)
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- čas přidán 7. 07. 2024
- In this 5th lesson, we compare DI vs SIADH. Diabetes Insipidus vs Syndrome of Inappropriate Anti Diuretic Hormone secretion. These are the 2 most common disorders of ADH that we will see in the ICU, and while they both deal with the same hormone, they are quite different from one another.
We start off with a quick review of the pathophysiology of ADH in our bodies before diving in the talking about Diabetes Insipidus (DI). We explain that this is from an insufficient amount or inadequate response to ADH and how this leads to massive urine output and volume loss. We talk about the different types, causes and patho for each before moving on to talk about the signs and symptoms you'd see, primarily related to the volume loss and hypernatremia. Finally we talk about how we diagnose DI as well as the treatment for diabetes insipidus.
Next we move on to talk about SIADH and how this is as a result of having too much ADH available, leading to no water excretion and essentially fluid overload and water intoxication. Again we quickly cover some of the MANY causes of SIADH and briefly hit on the patho for this one as well. Next we talk about the signs and symptoms and how we can divide these up in the early/mild and late/severe symptoms and what marks the difference between these. We also talk about the diagnosis before again moving on to talk about the treatment modalities for these patients.
Hopefully at the end of this less you will have a better understand of each of these disorders and how to not only recognize them in your patients, but how to properly treat them, as they both can be life threatening.
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Coming up in the next and last lesson, we will be taking a look at Thyroid Storme vs: *COMING SOON*
Don't forget to check out the playlist for this series of lessons here: • Endocrine System
Also check out these other great lessons and series of lessons below!
Hemodynamics Principals: • Hemodynamic Principals
Shock: • Shock
Arterial Blood Gases: • Arterial Blood Gases (...
ECG/EKG Rhythm Interpretation: • ECG/EKG Interpretation
Heart Failure: • Heart Failure
Blood Tubes - Order of Draw: • Order of Draw and Addi...
Glasgow Coma Scale: • Glasgow Coma Scale (GC...
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#EndocrineSystem #DI #SIADH #ICUAdvantage
So sad I only found you today. But, I am glad I found this page today and get so much clarifications on Endocrine problems.
Eddie!!! Thank you SO much! You have a natural talent for teaching! Thank you, thank you, thank you. This video helps make it stick!!! You’re videos have been so helpful to refer back to. Totally loving them ❤️
Woohoo!! You are so very welcome Adelaide! I really appreciate the kind words and it makes me happy to know others find these videos helpful.
GOOD JOB EDDIE!
Love your videos!!!! The best for nursing school!!
Thank you so much Alyssa! 😊 Glad they have been helpful for you.
Thanks a lot!
Thank you for clarifying the difference between these! This is a well detailed and understandable explanation!:)
So glad to hear this and happy to hear it was helpful
I agree
You said that DI causes you to be unable to dilute the urine. Do you mean unable to concentrate the urine? Since that's what ADH does. Love the videos though!
Yup! Definately a flip of words there! DI = extremely dilute urine.
Great cover 👍👍👍👍👍
Thank you!
Excelent work! Thank you for making this easier to understand.
Thank you so much Jose! Really appreciate the comment and glad it was helpful for you.
Thank you guys so much for watching! Please leave us a like if you enjoyed the video. We truly do appreciate it! Also we love hearing your comments so feel free to tell us what you think of the video. We hope that after this lesson, you will have a good understanding of the differences between DI and SIADH and what they share in common. You should be able to better identify each of these, what you would expect to see in your patients, as well as how we diagnose and treat each of them.
Don't forget to check out these other great lessons that we have available!
Hemodynamics: czcams.com/play/PL2oVjKTYocdMBZlcIcWlESbOFFaGugQS2.html
Shock: czcams.com/play/PL2oVjKTYocdPP0K8Fi49GfUgprICS-xMf.html
Blood Tubes - Order of Draw: czcams.com/video/mAmwdDdbkUI/video.html
Arterial Blood Gases: czcams.com/play/PL2oVjKTYocdMz1qF-3iS6iUZ-R_fKbeJw.html
ECG/EKG Interpretation: czcams.com/play/PL2oVjKTYocdPMaNwn4xbg6xAIaAnyraMj.html
Glasgow Coma Scale: czcams.com/video/zYwJVPIjW6I/video.html
Heart Failure: czcams.com/play/PL2oVjKTYocdNdFoS31yGhylKwib9lRf73.html
Don't forget to check us out and give us a like on Facebook as well! facebook.com/ICUAdvantage
ADH secreted by posterior pituitary gland
Thank you for finding time to respond to each and every questions from the confused 😁😁😁 I am okay with OPERATING ROOM, though. ICU will give me heart attack 😁😁😁
Haha, its defiantly a high stress environment thats for sure! :) I'm sure OR can be stressful too when it doesn't go well.
And I certainly try my best, but its getting harder and harder as the channel grows. I certainly am falling behind and probably soon won't be able to keep up with everyone :(
@5:45 Hi Eddie, shouldn't insufficient ADH or insensitivity to ADH lead to inability to concentrate the urine rather than diluting the urine? and ultimately a volume loss?
Just now seeing this comment. YES! I completely butchered that part. Not having the effect of ADH means we will not concentrate leading to dilute urine and thus the volume loss. Good catch.
That is what
I thought also. Ty for bringing this up😁
Hi Eddie. May I clarify the treatment to DI as far as fluid replacement? D5is isotonic and 1/2 NS is aka 0.45% saline is hypotonic right?
They both are hypotonic. D5W, the dextrose is metabolized leaving us pure water, making it hypo, and then yeah 1/2 NS is 0.45% NS, so hypotonic as well. 😊
I have diabetes insipidus. I was diagnosed when I was 6. I was happy to see you teach about it. Keep up the good work.
Hi Eddie can you tell me what you think this is pointing to?
Below low reference limit
Serum urea level 1.8 mmol/L [2.8 - 8.1]
Below low reference limit
Serum sodium level 133 mmol/L [136.0 - 145.0]
At the low end
GFR calculated abbreviated MDRD > 60 mL/min [60.0 - 90.0]
At the low end
Serum total protein level 66 g/L [66.0 - 87.0]
Urine: trace haemolysed blood
Urine protein test = trace
This is Claude's response "Based on the information provided, it appears you're referring to a set of laboratory test results, specifically blood and urine tests. Let me break down what these results might be indicating:
-Low serum urea (1.8 mmol/L): This is below the reference range (2.8 - 8.1 mmol/L). Low urea can sometimes indicate liver problems, malnutrition, or overhydration.
-Low serum sodium (133 mmol/L): This is slightly below the reference range (136.0 - 145.0 mmol/L), indicating mild hyponatremia. This could be due to various factors such as certain medications, hormonal issues, or excessive fluid intake.
-GFR (Glomerular Filtration Rate) at the low end of normal: This suggests kidney function is at the lower end of the normal range, which may warrant monitoring.
-Serum total protein at the low end of normal: This could potentially indicate issues with nutrition, liver function, or protein loss.
-Trace hemolyzed blood in urine: This suggests the presence of red blood cells in the urine, which could be due to various causes ranging from vigorous exercise to kidney or bladder issues.
-Trace protein in urine: This small amount of protein in the urine could be normal or might indicate early stages of kidney issues if persistent.
Taken together, these results might point to:
-Possible mild kidney function issues
-Potential electrolyte imbalance
-Possible nutritional concerns"
Did you know that thiazides are used to treat DI but can cause SIADH?! Can you explain?
Sorry I totally missed this comment. I actually wasn't aware of this but did some digging. Looks like its specifically for nephrogenic DI and prevents polyuria and increases urine osmolality. Seems counterintuitive to give a diuretic, but it sounds like the use of Thiazide causes Na and Cl levels to rise in the distal convoluted tubules, leading to adenosine to be released, causing vasoconstriction of afferent arterioles and thus a reduction in GFR. Pretty interesting!
Can you do cancer
Thanks for the suggestion!
Why is it that it’s called diabetes insipidus when it has nothing to do with diabetes or even the pancreas for that matter I’ve always wondered that. Really makes no sense.
My nursing textbook says that is called Diabetes because the signs are similar to DM. I agree that it does not make sense and that this disease is due for a rebranding.
Because it presents as similar symptoms (polyuria, polydipsia). It seems in the past doctors would taste the urine to differenciate between diabetes mellitus (sweet in latin) and insipidus (tasteless in latin). In the former, sugar in the urine pulls water in, and in the later, the absence of or insensibility to vasopressin prevents water resorption
@@simonparadis4159 thank you 😊
Posterior pg
Yup! 😊