Discussion post- week #7 adv path.
 
Describe the pathophysiology, clinical manifestations, evaluation, and treatment of two diseases of the posterior pituitary−syndrome of inappropriate antidiuretic hormone secretion (SIADH) and diabetes insipidus (DI).
Pathophysiology of the syndrome of inappropriate antidiuretic hormone secretion (SIADH) is characterized by the inability to suppress the secretion of antidiuretic hormone (ADH) which results in impaired excretion of water. Pathophysiology includes increased sodium and osmolality of urine, dilutional hyponatremia, ADH-induced water retention, reduced serum osmolality (Smedegaard, Jørgensen & Rittig, 2019). The disease is associated with neck and head and cancerous lung tumors as well as the nonmalignant lung disease. The lungs of patients synthesize and secrete vasopressin due to decreased oxygen and elevated CO2, a process that disrupts the clearance of water. On the other hand, diabetes insipidus (DI) causes head injury, brain tumors, and infections of the central nervous system. Excessive water intake causes dipsogenic DI while drug therapy causes nephrogenic DI. Discussion post- week #7 adv path.
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The clinical manifestations of DI include excretion of large quantities of dilute urine, uncontrollable, intense and excessive thirst. It is treated using IV hypotonic solutions with 0.45% salinity which helps to replace the excessive urine lost. Desmopressin is also used as the medical treatment choice for DI. It is evaluated using the water deprivation test. Glucose and serum electrolytes should also be measured through laboratory tests. Discussion post- week #7 adv path.
The clinical manifestation of SIADH are seizures, irritability, tremors and cramps, impairment of memory, depressed mood, nausea and vomiting, coma or stupor, hallucinations, and confusion. Evaluation involves testing of urine sodium concentration, urine osmolality, sodium osmolality, and euvolemic hyponatremia. Treatment entails the management of symptoms trough correction of sodium deficiency, restriction of water, loop diuretic and demeclocycline. In addition, vasopressin receptor antagonists such as tolvaptan and vaprisol inhibit the AVP V2 receptor which decreases the collecting ducts’ permeability from reduced number of aquaporin-2 channels of water (Smedegaard, Jørgensen & Rittig, 2019). Discussion post- week #7 adv path.