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Endocrinology MRCP 1
Diabetes Insipidus
Demonstration
Diabetes Insipidus
• Definition: Large volume (>3l/24hrs) of dilute
urine (<300 mOsmol/kg)
Types: Cranial and Nephrogenic
Cranial
• Lack of presence or ability to posterior
pituitary to secrete ADH
Familial: Autosomal dominant (vasopressin
gene)
Nephrogenic
• Lack of ADH action on kidney
Familial: X-linked recessive (V2 receptor
mutations) and
Autosomal recessive (AQP-2 mutations)
Causes
• Cranial: Head trauma, CNS tumours,
neurosurgery, pituitory/hypoth. disease,
granulomatous disease e.g. neurosarcoid, TB,
lymphocytic hypophysitis
• Nephrogenic: Drugs e.g. Lithium,
demeclocycline, hypercalcaemia,
hypokalaemia, hyperglycaemia, chronic renal
failure
Treatments
• Cranial: Tx Desmopressin – acts on V2
receptors of kidney
• Nephrogenic: Tx High dose
desmopressin/thiazide diuretics/NSAID e.g.
indomethican
• Side Effects: Fluid retention/hyponatraemia
Water deprivation test
• Urine concentration following water
deprivation test (mmol/L)
More
• For the corresponding video lecture presented
by Dr Andrew Solomon, free example exam
questions and access to the full eLecture
please visit:
www.123Doc.com

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Diabetes Insipidus - Endocrinology MRCP 1 - 123Doc Education

  • 1. Endocrinology MRCP 1 Diabetes Insipidus Demonstration
  • 2. Diabetes Insipidus • Definition: Large volume (>3l/24hrs) of dilute urine (<300 mOsmol/kg) Types: Cranial and Nephrogenic
  • 3. Cranial • Lack of presence or ability to posterior pituitary to secrete ADH Familial: Autosomal dominant (vasopressin gene)
  • 4. Nephrogenic • Lack of ADH action on kidney Familial: X-linked recessive (V2 receptor mutations) and Autosomal recessive (AQP-2 mutations)
  • 5. Causes • Cranial: Head trauma, CNS tumours, neurosurgery, pituitory/hypoth. disease, granulomatous disease e.g. neurosarcoid, TB, lymphocytic hypophysitis • Nephrogenic: Drugs e.g. Lithium, demeclocycline, hypercalcaemia, hypokalaemia, hyperglycaemia, chronic renal failure
  • 6. Treatments • Cranial: Tx Desmopressin – acts on V2 receptors of kidney • Nephrogenic: Tx High dose desmopressin/thiazide diuretics/NSAID e.g. indomethican • Side Effects: Fluid retention/hyponatraemia
  • 7. Water deprivation test • Urine concentration following water deprivation test (mmol/L)
  • 8. More • For the corresponding video lecture presented by Dr Andrew Solomon, free example exam questions and access to the full eLecture please visit: www.123Doc.com