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Posterior Pituitary Syndrome

Roles Syndrome of Inappropriate Secretion of ADH (SIADH)

ADH
Control amount of H2O reabsorbed
Acts in Distal Portion of Renal Tubule
• Distal Convulated Tubule
• Collecting Duct
Retention of H2O (Not Solute)
Dilutes Blood (↓ [Na])
Oxytocin
Contraction of Uterus during Labour
Stimulates Milk Flow from Breasts
(contraction of muscle fibres in milk
ducts)
Definition
Characterized by
Excessive release of ADH from Posterior Pituitary
Results in Hyponatraemia, Fluid Overload
1° condition that results in Abnormal Handling of H2O
Not excessive Solute Loss

Diabetes Insipidus (DI) Causes

Meningitis
Definition Lung Cancer
Characterized by Head Trauma
Excessive Thirst Brain Tumour
Excretion of ↑ amou nts of severely Diluted Urine Drugs
(↓ Fluid Intake having no effect)
Due to Pathophysiol ogy
Inability of Renal Tubular Cells to Reabsorb H2O properly from Urine Release of ADH not Inhibited by ↓ in Plasma Osmolality
(When H2O Intake, Osmolality of Plasma ↓)
Classification ↓
Central/ Neurogenic Nephrogenic ↓ Na Detected (laboratory testing)
Insuffi cient Production, Secretion of Lack of Kidney response to normal (Na is main solute in Plasma)
ADH levels of ADH ↓
Result from damage to pituitary gland Caused by SIADH
Caused by • Drugs
• Brain Injuries • Chronic Disorders Symptoms
• Genetic Disorders o Kidney Failure Nausea
o Sickle Cell Disease Vomiting
o Polycystic Kidney Disease Irritability
Personality changes
Pathophysiol ogy • Combativeness
Central/ Neurogenic Nephrogenic • Confusi on
Destruction of Vasopression Receptors • Hallucinations
Hypothalamus (Aquaporin-2 H2O channels) Seizures
Hypothalamus-Hypophyseal Tract Acquired sensitivity to drugs Stupor
Posterior Pituitary ↓ Coma
↓ Loss of Kid ney’s Response to ADH
↓ Secretion of ADH ↓ Treatment
↓ ↓ Reabsorption of H2O Fluid restriction
↓ Reabsorption of H2O from Urine at Renal Tubular Cells IV Saline
from Urine at Renal Tubular Cells ↓ Drugs
↓ Dilute Urine • Demeclocycline
Dilute Urine Polyuria
• Conivaptan
Polyuria Polydipsia
• Tolvaptan
Polydipsia

Causes
Head Trauma
Surgery
Tumour
Tuberculosis
Meningitis
Sarcoidosis
Family Hereditary

Symptoms
Urinary Frequency
Nocturia
Enuresis
Pale Urine

Treatment
Adequate Hydration
Central/ Neurogenic Nephrogenic
Desmopressin Diuretic Hydrochlorothiazide
Carbamazepine