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Adrenal cortical carcinoma
Primary adrenal insufficiency
Congenital adrenal hyperplasia
Multiple endocrine neoplasia
Opsoclonus myoclonus syndrome (NORD)
Pancreatic neuroendocrine neoplasms
Androgen insensitivity syndrome
Polycystic ovary syndrome
Premature ovarian failure
Constitutional growth delay
Growth hormone deficiency
Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Autoimmune polyglandular syndrome type 1 (NORD)
Thyroglossal duct cyst
Thyroid eye disease (NORD)
Toxic multinodular goiter
Euthyroid sick syndrome
Subacute granulomatous thyroiditis
Adrenal insufficiency: Pathology review
Adrenal masses: Pathology review
Cushing syndrome and Cushing disease: Pathology review
Diabetes insipidus and SIADH: Pathology review
Diabetes mellitus: Pathology review
Hyperthyroidism: Pathology review
Hypopituitarism: Pathology review
Hypothyroidism: Pathology review
Multiple endocrine neoplasia: Pathology review
Neuroendocrine tumors of the gastrointestinal system: Pathology review
Parathyroid disorders and calcium imbalance: Pathology review
Pituitary tumors: Pathology review
Thyroid nodules and thyroid cancer: Pathology review
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Running with Diabetes Insipidus
Diabetes Insipidus Assessment
Diabetes Insipidus & SIADH
for diabetes insipidus p. 349
in diabetes insipidus p. 342
diabetes insipidus and p. 248, 349
antidiuretic hormone in p. 338
demeclocycline and p. 362
desmopressin acetate for p. 362
drug reaction and p. 248
lithium p. 594
lithium toxicity p. 589
potassium-sparing diuretics for p. 629
thiazides for p. 629
for diabetes insipidus p. 342
diabetes insipidus p. 349
diabetes insipidus p. 342
With diabetes insipidus, “diabetes” means an increased passing of urine, and “insipidus” means tasteless; so diabetes insipidus is a condition characterized by the production of large quantities of dilute and tasteless urine.
The tasteless urine of diabetes insipidus distinguishes it from diabetes mellitus which describes sweet tasting urine- and, yes, urine was really tasted at one point in time to make that distinction!
Now, in the brain there’s a region called the hypothalamus.
Inside the hypothalamus are osmoreceptors, which can sense the osmolality of the blood, or how concentrated it is.
Osmolality is the concentration of dissolved particles in the blood plasma, or the liquid portion of blood.
There are a number of dissolved particles in the blood plasma, but the major ones are glucose, sodium, and blood urea nitrogen, and a normal osmolality is between 285 and 295 milli Osmoles per kilogram.
During periods of dehydration there is an increase in concentration of these particles in the blood and osmolality increases.
The osmoreceptors in the hypothalamus detect the increased osmolality and that triggers the sensation of thirst, which tells us to drink more water. The water then gets absorbed and dilutes the blood, bringing the osmolality back to normal.
In addition to osmoreceptors, the hypothalamus also contains a cluster of neurons that are found in a specific spot called the supraoptic nucleus.
These neurons produce a hormone called antidiuretic hormone, or ADH. ADH is also called vasopressin because it causes smooth muscle around the blood vessels to contract, which increases blood resistance and raises blood pressure.
When the osmoreceptors detect high osmolality, they signal the supraoptic nucleus to send ADH down the supraoptico-hypophyseal tract, which runs through the infundibulum or pituitary stalk, and into the posterior pituitary gland, where it is then released into the blood.
Diabetes insipidus is when the body cannot regulate its fluid levels properly and loses a lot of water in the urine. There are two major types of diabetes insipidus, which are central and nephrogenic diabetes insipidus. Central diabetes insipidus occurs when the hypothalamus is not producing enough antidiuretic hormone (ADH). ADH ensures that the kidneys produce less urine and reduce water loss. On the other hand, nephrogenic diabetes insipidus results from the kidneys failing to respond to ADH. People with diabetes insipidus present with excessive quantities of diluted urine (polyuria), resulting in excessive thirst (polydipsia).
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