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Old 05-17-2012
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Help SIADH and Diabetes insipidus tests

Hello doctors,

when do we ask for ADH levels? I'm thinking of asking it if a patient comes with asymptomatic euvolemic hyponaterimia to differentiate between SIADH from hypothyroidism/adrenal insufficiency? Do you agree?

Now for Diabetes insipidus, let's say we get a case with typical symptoms with high serum osmolality and low urine osmol.. and the patient on lithium...what do you think the next step should be? water deprivation test or begin with treatment (hydrochorthiazide; considering it a nephrogenic D.I due to the history of lithium intake)?
I mean if the question gives a clue about the etiology of the D.I I have to do water deprivation test anyway?

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Old 05-18-2012
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i solved multiple question regarding this topic
if the cause if clear from the Hx they are going to ask either what is the Rx or what is the Dx, Not the Dx test usually.
they gonna give the typical lab abnl (high serum Na,Osmo, Low urine Na,Osmo, nl glucose, and what happen after water deprivation test) most ques i encounter already mentioned water deprivation test.
but what is the scenario in which we should order water deprivation test or ADH response. i dont know. i think the question have to be too short without any details, just a pt who's peeing alot and drinking alot, what's the next step
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The above post was thanked by:
halabian (05-19-2012), Noa2013 (07-20-2014)



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