SlideShare uma empresa Scribd logo
1 de 52
SIADH SYNDROME OF INAPPROPRIATE SECRETION OF ANTI DIURETIC HORMONE 22.12.10
Outline Of The Presentation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Introduction ,[object Object],[object Object],[object Object]
Prevalance of hyponatremia ,[object Object],[object Object],Sajadieh A.AJEM 2009  122  679–686  . Gankam Kengne F.QJOM 2008  101  583–588
[object Object],[object Object],Zilberberg MD  BMC Pulmonary Medicine  2008  8  16. Sherlock M  Endocrinology  2006  64  250–254
ADH:  AntiDiuretic Hormone ,[object Object],[object Object],[object Object]
 
Function of ADH  ,[object Object],[object Object],[object Object],[object Object]
[object Object]
Syndrome of Inappropriate    AntiDiuretic Hormone ,[object Object],[object Object]
…… .SIADH……. ,[object Object],[object Object],[object Object]
Cardiac failure or cirrhosis on diuretic therapy   Cirrhosis Cardiac failure Nephrotic syndrome Peripheral oedema Ascites Raised JVP Pulmonary oedema Underlying illness Hypervolaemic   SIADH ACTH deficiency Hypothyroidism SIADH with ongoing fluid restriction Primary polydipsia Inappropriate fluid replacement Underlying illness   Euvolaemic Diuretics Addison's disease Cerebral salt wasting Salt wasting nephropathy GI losses, Mucosal losses, Pancreatitis Sodium depletion post diuretics Dry mucous membranes, Decreased turgor, Tachycardia, Hypotension (orthostatic), Raised urea, rennin Hypovolaemic   Urinary Na+>40  mmol/l  Urinary Na+<20  mmol/l  Clinical signs
[object Object],[object Object]
[object Object],[object Object],[object Object]
[object Object],[object Object]
[object Object],[object Object],[object Object],M J Hannon. European Journal of Endocrinology,2010. Vol 162
Causes of SIADH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes of SIADH ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Classification of SIADH  ,[object Object],[object Object],Zerbe R  Annual Review of Medicine  1980  31  315–327
Type A SIADH  ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
Type B SIADH ,[object Object],[object Object],[object Object],[object Object]
Type C SIADH ,[object Object],[object Object],[object Object]
Type D SIADH ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Copyright ©2010 European Society of Endocrinology Eur J Endocrinol. 2010 Jun;162(Suppl1):S5-S12 Figure 1 Summary of the four different patterns of AVP secretion in SIADH
CLINICAL FEATURES ,[object Object],[object Object],[object Object]
CLINICAL FEATURES ,[object Object],[object Object],[object Object]
Laboratory Evaluation  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Table 1  Diagnostic criteria for SIADH  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TREATMENT ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
Isotonic saline ,[object Object],[object Object],[object Object]
Hypertonic saline ,[object Object],[object Object]
The Adrogué–Madias formula ,[object Object],[object Object]
Simple Rule Of Thumb ,[object Object],[object Object]
Demeclocycline ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Lithium ,[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object]
Urea ,[object Object],[object Object],[object Object],[object Object],[object Object]
Extracorporeal treatments ,[object Object],[object Object],[object Object]
The vaptans  ,[object Object],[object Object],[object Object],[object Object],[object Object]
V2 receptor antagonists in the treatment of SIADH. ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
How should treatment be monitored?   ,[object Object],[object Object],[object Object]
SUMMARY ,[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object]
THANK YOU

Mais conteúdo relacionado

Mais procurados

Anemia in Chronic Kidney DIsease
Anemia in Chronic Kidney DIseaseAnemia in Chronic Kidney DIsease
Anemia in Chronic Kidney DIsease
Vishal Golay
 

Mais procurados (20)

Pitfalls in estimating renal failure in the elderly by eGFR
Pitfalls in estimating renal failure in the elderly by eGFRPitfalls in estimating renal failure in the elderly by eGFR
Pitfalls in estimating renal failure in the elderly by eGFR
 
Interpretation of laboratory thyroid function tests
Interpretation of laboratory thyroid function tests Interpretation of laboratory thyroid function tests
Interpretation of laboratory thyroid function tests
 
Anemia of chronic disease
Anemia of chronic diseaseAnemia of chronic disease
Anemia of chronic disease
 
Thyroid function tests
Thyroid function testsThyroid function tests
Thyroid function tests
 
Hemochromatosis liver
Hemochromatosis liverHemochromatosis liver
Hemochromatosis liver
 
Siadh (1)
Siadh (1)Siadh (1)
Siadh (1)
 
Hemolytic uremic syndrome
Hemolytic uremic syndrome Hemolytic uremic syndrome
Hemolytic uremic syndrome
 
Porphyria the vampire disease
Porphyria  the vampire diseasePorphyria  the vampire disease
Porphyria the vampire disease
 
SIADH
SIADHSIADH
SIADH
 
Hypernatremia
HypernatremiaHypernatremia
Hypernatremia
 
Acromegaly
AcromegalyAcromegaly
Acromegaly
 
Anemia in Chronic Kidney DIsease
Anemia in Chronic Kidney DIseaseAnemia in Chronic Kidney DIsease
Anemia in Chronic Kidney DIsease
 
Electrolytes & Acid-Base Disturbance Workshop - Dr. Gawad
Electrolytes & Acid-Base Disturbance Workshop - Dr. GawadElectrolytes & Acid-Base Disturbance Workshop - Dr. Gawad
Electrolytes & Acid-Base Disturbance Workshop - Dr. Gawad
 
RENAL TUBULAR ACIDOSIS
RENAL TUBULAR ACIDOSISRENAL TUBULAR ACIDOSIS
RENAL TUBULAR ACIDOSIS
 
Phaeochromocytoma
PhaeochromocytomaPhaeochromocytoma
Phaeochromocytoma
 
Hemochromatosis presentation
Hemochromatosis presentationHemochromatosis presentation
Hemochromatosis presentation
 
Anemia in ckd
Anemia in ckdAnemia in ckd
Anemia in ckd
 
Chronic kidney disease
Chronic kidney diseaseChronic kidney disease
Chronic kidney disease
 
Uremia
UremiaUremia
Uremia
 
Secondary hypertension - Etiopathogenesis, Clinical features, Advances in Man...
Secondary hypertension - Etiopathogenesis, Clinical features, Advances in Man...Secondary hypertension - Etiopathogenesis, Clinical features, Advances in Man...
Secondary hypertension - Etiopathogenesis, Clinical features, Advances in Man...
 

Destaque

Ppt lung carcinoma part1
Ppt lung carcinoma part1Ppt lung carcinoma part1
Ppt lung carcinoma part1
Juned Khan
 
Parhon Syndrome/SIADH
Parhon Syndrome/SIADHParhon Syndrome/SIADH
Parhon Syndrome/SIADH
Shakti Yeoh
 
Anaesthesia and disorders of adrenal cortex
Anaesthesia and disorders of adrenal cortexAnaesthesia and disorders of adrenal cortex
Anaesthesia and disorders of adrenal cortex
Dhritiman Chakrabarti
 

Destaque (20)

Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)
Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)
Syndrome of Inappropriate Anti-diuretic Hormone Secretion (SIADH)
 
SIADH
SIADHSIADH
SIADH
 
Ppt lung carcinoma part1
Ppt lung carcinoma part1Ppt lung carcinoma part1
Ppt lung carcinoma part1
 
Cerebral salt wasting and siadh
Cerebral salt wasting and siadhCerebral salt wasting and siadh
Cerebral salt wasting and siadh
 
Parhon Syndrome/SIADH
Parhon Syndrome/SIADHParhon Syndrome/SIADH
Parhon Syndrome/SIADH
 
SIADH
SIADHSIADH
SIADH
 
A Case of Bartter's Syndrome
A Case of Bartter's SyndromeA Case of Bartter's Syndrome
A Case of Bartter's Syndrome
 
Anaesthesia and disorders of adrenal cortex
Anaesthesia and disorders of adrenal cortexAnaesthesia and disorders of adrenal cortex
Anaesthesia and disorders of adrenal cortex
 
Concept Map of Syndrome of Inappropriate (ly high) Anti-Diuretic Hormone (SIADH)
Concept Map of Syndrome of Inappropriate (ly high) Anti-Diuretic Hormone (SIADH)Concept Map of Syndrome of Inappropriate (ly high) Anti-Diuretic Hormone (SIADH)
Concept Map of Syndrome of Inappropriate (ly high) Anti-Diuretic Hormone (SIADH)
 
adrenal glands disorder
adrenal glands disorderadrenal glands disorder
adrenal glands disorder
 
Hyponatraemia (Case Presentation)
Hyponatraemia (Case Presentation)Hyponatraemia (Case Presentation)
Hyponatraemia (Case Presentation)
 
Di, siadh and cerebral salt wasting syndrome
Di, siadh and cerebral salt wasting syndromeDi, siadh and cerebral salt wasting syndrome
Di, siadh and cerebral salt wasting syndrome
 
Small Cell Carcinoma of Lung
Small Cell Carcinoma of LungSmall Cell Carcinoma of Lung
Small Cell Carcinoma of Lung
 
Sodium metabolism and disorders
Sodium metabolism and disordersSodium metabolism and disorders
Sodium metabolism and disorders
 
Tay sachs DISEASE
 Tay sachs DISEASE Tay sachs DISEASE
Tay sachs DISEASE
 
Hyponatremia
HyponatremiaHyponatremia
Hyponatremia
 
Syndrome of inappropriate antidiuretic hormone secretion
Syndrome of inappropriate antidiuretic hormone secretionSyndrome of inappropriate antidiuretic hormone secretion
Syndrome of inappropriate antidiuretic hormone secretion
 
Antidiuretics
AntidiureticsAntidiuretics
Antidiuretics
 
Anti Diuretic Hormone
Anti Diuretic HormoneAnti Diuretic Hormone
Anti Diuretic Hormone
 
Tolvaptan
TolvaptanTolvaptan
Tolvaptan
 

Semelhante a 20 sep 2010 siadh

shock types management
shock types managementshock types management
shock types management
drsvignesh78
 
Acute Poststreptococcal Glomerulonephritis
Acute Poststreptococcal GlomerulonephritisAcute Poststreptococcal Glomerulonephritis
Acute Poststreptococcal Glomerulonephritis
Hakimah Suhaimi
 

Semelhante a 20 sep 2010 siadh (20)

Haemoglobinopathies thalassemia, prophyrias and sickle cell disease-
Haemoglobinopathies  thalassemia, prophyrias and sickle cell disease-Haemoglobinopathies  thalassemia, prophyrias and sickle cell disease-
Haemoglobinopathies thalassemia, prophyrias and sickle cell disease-
 
Hyper function of adrenal
Hyper function of adrenalHyper function of adrenal
Hyper function of adrenal
 
uproach to anemia in ICU
uproach to anemia in ICUuproach to anemia in ICU
uproach to anemia in ICU
 
Complications of Haemodialysis
Complications of HaemodialysisComplications of Haemodialysis
Complications of Haemodialysis
 
hyponatremiaandhypernatremia-160310202741.pdf
hyponatremiaandhypernatremia-160310202741.pdfhyponatremiaandhypernatremia-160310202741.pdf
hyponatremiaandhypernatremia-160310202741.pdf
 
Hyponatremia and hypernatremia
Hyponatremia and hypernatremiaHyponatremia and hypernatremia
Hyponatremia and hypernatremia
 
Hemodialysis catastrope
Hemodialysis catastropeHemodialysis catastrope
Hemodialysis catastrope
 
Cirrosis of liver and its complication and traetment of hep b and c
Cirrosis of liver and its complication and traetment of hep b and cCirrosis of liver and its complication and traetment of hep b and c
Cirrosis of liver and its complication and traetment of hep b and c
 
hyponatremia final.pptx
hyponatremia final.pptxhyponatremia final.pptx
hyponatremia final.pptx
 
MYXOEDEMA COMA
MYXOEDEMA COMAMYXOEDEMA COMA
MYXOEDEMA COMA
 
Endocrine hypertension
Endocrine hypertensionEndocrine hypertension
Endocrine hypertension
 
Hyponatremia 040113.ppt
Hyponatremia 040113.pptHyponatremia 040113.ppt
Hyponatremia 040113.ppt
 
Hyponatremia 040113 (1)
Hyponatremia 040113 (1)Hyponatremia 040113 (1)
Hyponatremia 040113 (1)
 
shock types management
shock types managementshock types management
shock types management
 
Hyponatremia and hypernatremia 2015
Hyponatremia and hypernatremia  2015Hyponatremia and hypernatremia  2015
Hyponatremia and hypernatremia 2015
 
Hyponatremia and hypernatremia 2015
Hyponatremia and hypernatremia  2015Hyponatremia and hypernatremia  2015
Hyponatremia and hypernatremia 2015
 
Acute Poststreptococcal Glomerulonephritis
Acute Poststreptococcal GlomerulonephritisAcute Poststreptococcal Glomerulonephritis
Acute Poststreptococcal Glomerulonephritis
 
Approach to hyponatremia
Approach to hyponatremiaApproach to hyponatremia
Approach to hyponatremia
 
Diabetes insipidus by lahari
Diabetes insipidus by lahariDiabetes insipidus by lahari
Diabetes insipidus by lahari
 
Sickle cell disease
Sickle cell diseaseSickle cell disease
Sickle cell disease
 

Mais de Vishal Golay

Acid base and control for the dialysis technician
Acid base and control for the dialysis technicianAcid base and control for the dialysis technician
Acid base and control for the dialysis technician
Vishal Golay
 
Deceased donor kidney transplantation-Recipient care.
Deceased donor kidney transplantation-Recipient care.Deceased donor kidney transplantation-Recipient care.
Deceased donor kidney transplantation-Recipient care.
Vishal Golay
 
SLE: present guidelines and consensus
SLE: present guidelines and consensusSLE: present guidelines and consensus
SLE: present guidelines and consensus
Vishal Golay
 
Basics of peritoneal dialysis
Basics of peritoneal dialysisBasics of peritoneal dialysis
Basics of peritoneal dialysis
Vishal Golay
 
Bk virus nephropathy
Bk virus nephropathyBk virus nephropathy
Bk virus nephropathy
Vishal Golay
 
Year in review 2011-Nature reviews
Year in review 2011-Nature reviewsYear in review 2011-Nature reviews
Year in review 2011-Nature reviews
Vishal Golay
 
Membranous nephropathy
Membranous nephropathyMembranous nephropathy
Membranous nephropathy
Vishal Golay
 
Contrast induced acute kidney injury
Contrast induced acute kidney injuryContrast induced acute kidney injury
Contrast induced acute kidney injury
Vishal Golay
 
Interpretation of the Arterial Blood Gas analysis
Interpretation of the Arterial Blood Gas analysisInterpretation of the Arterial Blood Gas analysis
Interpretation of the Arterial Blood Gas analysis
Vishal Golay
 
PRCA post renal transplant-a case and review
PRCA post renal transplant-a case and reviewPRCA post renal transplant-a case and review
PRCA post renal transplant-a case and review
Vishal Golay
 
Transplantation in sensitized patients(seminar)
Transplantation in sensitized patients(seminar)Transplantation in sensitized patients(seminar)
Transplantation in sensitized patients(seminar)
Vishal Golay
 

Mais de Vishal Golay (19)

Acid base and control for the dialysis technician
Acid base and control for the dialysis technicianAcid base and control for the dialysis technician
Acid base and control for the dialysis technician
 
Deceased donor kidney transplantation-Recipient care.
Deceased donor kidney transplantation-Recipient care.Deceased donor kidney transplantation-Recipient care.
Deceased donor kidney transplantation-Recipient care.
 
Approach to deceased donor transplantation
Approach to deceased donor transplantationApproach to deceased donor transplantation
Approach to deceased donor transplantation
 
SLE: present guidelines and consensus
SLE: present guidelines and consensusSLE: present guidelines and consensus
SLE: present guidelines and consensus
 
Basics of peritoneal dialysis
Basics of peritoneal dialysisBasics of peritoneal dialysis
Basics of peritoneal dialysis
 
Bk virus nephropathy
Bk virus nephropathyBk virus nephropathy
Bk virus nephropathy
 
Year in review 2011-Nature reviews
Year in review 2011-Nature reviewsYear in review 2011-Nature reviews
Year in review 2011-Nature reviews
 
Membranous nephropathy
Membranous nephropathyMembranous nephropathy
Membranous nephropathy
 
Contrast induced acute kidney injury
Contrast induced acute kidney injuryContrast induced acute kidney injury
Contrast induced acute kidney injury
 
Water treatment and quality control of dialysate.
Water treatment and quality control of dialysate.Water treatment and quality control of dialysate.
Water treatment and quality control of dialysate.
 
Interpretation of the Arterial Blood Gas analysis
Interpretation of the Arterial Blood Gas analysisInterpretation of the Arterial Blood Gas analysis
Interpretation of the Arterial Blood Gas analysis
 
PRCA post renal transplant-a case and review
PRCA post renal transplant-a case and reviewPRCA post renal transplant-a case and review
PRCA post renal transplant-a case and review
 
Diuretics in CKD
Diuretics in CKDDiuretics in CKD
Diuretics in CKD
 
Transplantation in sensitized patients(seminar)
Transplantation in sensitized patients(seminar)Transplantation in sensitized patients(seminar)
Transplantation in sensitized patients(seminar)
 
Nephrocalcinosis
NephrocalcinosisNephrocalcinosis
Nephrocalcinosis
 
Seminar on renal tuberculosis
Seminar on renal tuberculosisSeminar on renal tuberculosis
Seminar on renal tuberculosis
 
Induction agents in renal transplantation
Induction agents in renal transplantationInduction agents in renal transplantation
Induction agents in renal transplantation
 
Dialysis statistics(Jan-April'11)
Dialysis statistics(Jan-April'11)Dialysis statistics(Jan-April'11)
Dialysis statistics(Jan-April'11)
 
Renal biopsy seminar
Renal biopsy seminarRenal biopsy seminar
Renal biopsy seminar
 

Último

Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
mahaiklolahd
 

Último (20)

VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
VIP Hyderabad Call Girls Bahadurpally 7877925207 ₹5000 To 25K With AC Room 💚😋
 
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service AvailableCall Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available
 
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...Top Rated  Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
Top Rated Hyderabad Call Girls Erragadda ⟟ 9332606886 ⟟ Call Me For Genuine ...
 
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...
 
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
Independent Call Girls Service Mohali Sector 116 | 6367187148 | Call Girl Ser...
 
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
Premium Call Girls In Jaipur {8445551418} ❤️VVIP SEEMA Call Girl in Jaipur Ra...
 
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service AvailableTrichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
Trichy Call Girls Book Now 9630942363 Top Class Trichy Escort Service Available
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on WhatsappMost Beautiful Call Girl in Bangalore Contact on Whatsapp
Most Beautiful Call Girl in Bangalore Contact on Whatsapp
 
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service AvailableCall Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
Model Call Girls In Chennai WhatsApp Booking 7427069034 call girl service 24 ...
 
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...
 
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
Models Call Girls In Hyderabad 9630942363 Hyderabad Call Girl & Hyderabad Esc...
 
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
9630942363 Genuine Call Girls In Ahmedabad Gujarat Call Girls Service
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...
 
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls  * UPA...
Call Girl in Indore 8827247818 {LowPrice} ❤️ (ahana) Indore Call Girls * UPA...
 
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...
 
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
The Most Attractive Hyderabad Call Girls Kothapet 𖠋 9332606886 𖠋 Will You Mis...
 

20 sep 2010 siadh

  • 1. SIADH SYNDROME OF INAPPROPRIATE SECRETION OF ANTI DIURETIC HORMONE 22.12.10
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.  
  • 8.
  • 9.
  • 10.
  • 11.
  • 12. Cardiac failure or cirrhosis on diuretic therapy Cirrhosis Cardiac failure Nephrotic syndrome Peripheral oedema Ascites Raised JVP Pulmonary oedema Underlying illness Hypervolaemic SIADH ACTH deficiency Hypothyroidism SIADH with ongoing fluid restriction Primary polydipsia Inappropriate fluid replacement Underlying illness Euvolaemic Diuretics Addison's disease Cerebral salt wasting Salt wasting nephropathy GI losses, Mucosal losses, Pancreatitis Sodium depletion post diuretics Dry mucous membranes, Decreased turgor, Tachycardia, Hypotension (orthostatic), Raised urea, rennin Hypovolaemic Urinary Na+>40 mmol/l Urinary Na+<20 mmol/l Clinical signs
  • 13.
  • 14.
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27. Copyright ©2010 European Society of Endocrinology Eur J Endocrinol. 2010 Jun;162(Suppl1):S5-S12 Figure 1 Summary of the four different patterns of AVP secretion in SIADH
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46.
  • 47.
  • 48.
  • 49.
  • 50.
  • 51.