Question

- Diabetes Insipidus and Syndrome of Inappropriate Antidiuretic Hormone (SIADH) In table format, compare and contrast Diabetes Insipidus and SIADH. Include the following elements in your table: Causative Agent Risk Factors Pathophysiology Manifestations Treatment

Answer 1

	Diabetes Insipidus	Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Description	It is a medical condition or disorder of water and salt metabolism marked by heavy urination and intense thirst.	SIADH is characterized by an increased and unsuppressible release of ADH either from an abnormal non-pituitary source and posterior pituitary gland.
Causative Agent	· Kidneys are not receptive to antidiuretic hormone secretion (ADH) · Tumour · Harm to the hypothalamus and/or the pituitary gland · Brain damage or trauma through head injury or stroke · Complications that happen during pituitary surgery or brain · Drugs like Declomycin. This drug inhibits ADH production.	· Mental status changes · Nausea, vomiting, Coma, Cerebral oedema, seizures · Liver disease · Hypothyroidism · Adrenal insufficiency · Eco-topic tumour production · Pulmonary disease/lung cancer · Guillain-Barré syndrome
Risk Factors	· Genetics. · Polycystic kidney disease. · Pituitary disorders. · Hypothalamic injury. · Hypercalcemia. · Head tumors. · Pregnancy. · Sickle cell disease.	SIADH tends to occur in people with heart failure or people with a diseased hypothalamus. In some cases, a certain cancer may produce the antidiuretic hormone, especially certain lung cancers.
Pathophysiology Manifestations	1. Decreased ADH 2. Decreased water absorption in renal tubules 3. Decreased intravascular fluid volume 4. A) Increased serum osmolality (hypernatremia) B) Excessive urine out put	1. Increased ADH 2. Increased Aquaporins 3. Dilute blood (more water retained) 4. Dilutes sodium +takes up more space 5. Decreased aldosterone 6. Decreased sodium(water follows salt) 7. SIADH
Treatment	Central diabetes insipidus Ttreatment with a man-made hormone known as desmopressin which replaces the missing ADH (anti-diuretic hormone) and bring down peeing capacity. Other medications are chlorpropamide and indomethacin. These medications can make anti-diuretic hormone Nephrogenic diabetes insipidus Low-salt diet to assist in decreasing the amount of urine the kidneys make. Drinking enough water to avoid dehydration is also recommended. Medicines like hydrochlorothiazide (Microzide) helps in improving the symptoms. Gestational diabetes insipidus · Treatment for gestational diabetes insipidus is with the synthetic hormone desmopressin.	Medications Drugs for treatment include: · Demeclocycline – the most potent inhibitor of Vasopressin (ADH/AVP) action. · An antagonist of the V2 vasopressin receptor -Tolvaptan · An antagonist of both V1A and V2 vasopressin receptors – Conivaptan Diuretic Increases urine production to remove excess water and salt. Antibiotics Kills or stops the growth of bacteria. If the SIADH condition is chronic, fluid restriction has to be permanently followed.