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  #1  
Old 08-18-2011
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Default Hyponatermia and Hypothyroidism!

guys,
anyone explain the relation.
This is given on MTB2 page 108.

thanks!
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  #2  
Old 08-18-2011
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Post why hyponatermia

hyponatremia in hypopituitary could be becoz of hypothyroid ...the following abstract is taken from uptodate


The mechanism by which hypothyroidism induces hyponatremia is incompletely understood. The principal abnormality in patients with normal fluid intake appears to be an inability to maximally suppress antidiuretic hormone [1-3]. This is due in part to a reduced cardiac output, which can lead to the release of antidiuretic hormone via the carotid sinus baroreceptors [2,3,6]. In addition, some patients fulfill criteria for the syndrome of inappropriate antidiuretic hormone secretion since the urine sodium is not low as would be expected if a reduced cardiac output were responsible [7].
The glomerular filtration is also decreased in hypothyroidism. This can directly diminish free water excretion by diminishing water delivery to the diluting segments [4,5]. Decreased delivery may be particularly important in those cases in which hyponatremia develops despite appropriate suppression of ADH release [8,9].
Regardless of the mechanism, the net effect of the impairment in water excretion is the retention of ingested water and a reduction in the plasma sodium concentration by dilution.


according to some journals..hyponatremia is sometimes the only clue to the hypopituitarism pts who present with either subtle clinical pictures or as pts in shock and actely deconpensated
bottom line:memorise..hyponatremia is a major clue pointer to hypopituitarism
hope it helped
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  #3  
Old 08-18-2011
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Originally Posted by samstar View Post
hyponatremia in hypopituitary could be becoz of hypothyroid ...the following abstract is taken from uptodate


The mechanism by which hypothyroidism induces hyponatremia is incompletely understood. The principal abnormality in patients with normal fluid intake appears to be an inability to maximally suppress antidiuretic hormone [1-3]. This is due in part to a reduced cardiac output, which can lead to the release of antidiuretic hormone via the carotid sinus baroreceptors [2,3,6]. In addition, some patients fulfill criteria for the syndrome of inappropriate antidiuretic hormone secretion since the urine sodium is not low as would be expected if a reduced cardiac output were responsible [7].
The glomerular filtration is also decreased in hypothyroidism. This can directly diminish free water excretion by diminishing water delivery to the diluting segments [4,5]. Decreased delivery may be particularly important in those cases in which hyponatremia develops despite appropriate suppression of ADH release [8,9].
Regardless of the mechanism, the net effect of the impairment in water excretion is the retention of ingested water and a reduction in the plasma sodium concentration by dilution.


according to some journals..hyponatremia is sometimes the only clue to the hypopituitarism pts who present with either subtle clinical pictures or as pts in shock and actely deconpensated
bottom line:memorise..hyponatremia is a major clue pointer to hypopituitarism
hope it helped
too complex and confusing to remember! looks lyk i have to book a slot in my memory for this one!!!! lol
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Old 08-18-2011
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Originally Posted by cool_atomic View Post
too complex and confusing to remember! looks lyk i have to book a slot in my memory for this one!!!! lol
Here is a more summarized version..... Hyponatremia from hypothyroidism is cause by a decrease in free water clearance in the kidney....So more Na is cleared..there for triggering hyponatremia...hope it helps..
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Old 08-18-2011
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best of luck cool atomic....i have a gut feeling u r goin to ace the exam...will make a special pray for u on ur exam day
@kais.....lol...ok thnks for pointing out...i had gotten that one wrong..looks like i need towork harder
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  #6  
Old 08-18-2011
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Originally Posted by samstar View Post
best of luck cool atomic....i have a gut feeling u r goin to ace the exam...will make a special pray for u on ur exam day
@kais.....lol...ok thnks for pointing out...i had gotten that one wrong..looks like i need towork harder
and actually towards the end you said its retention of excess water which causes dilution of the plasma..which is basically decrease of free water clearance....

lol sorry honestly i didnt read yours...since i am taking mine in about 6 days..the best advice i can give you is to get mtb2 and MTB internal Medicine...Its amazing plus it helps alot since step 2 is 50% internal Medicine...
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Old 08-18-2011
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Smile best of luck

thnks for the advice kais-MD..will be following ur foot steps in giving the exam in 15 days time....best of luck to u too and do come back on the forum n let us know how it went..esp witht he abstract questions.will bw waiting ofr ur feed back
keep posting corrections on my post..need it till my exams
tc
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