SIADH - ✔✔Abnormal release of ADH in the presence of a normal osmolality results in the
reabsorption of too much water.
SIADH causes - ✔✔Drug-induced: Chemotherapy drugs that can increase ADH activity
Neoplasms:
Tumors may also synthesize and release ADH autonomously
SIADH Signs and Symptoms - ✔✔Moderate SIADH:
Progressive neurologic symptoms
Lethargy
Abdominal cramping and diarrhea
Oliguria/concentrated urine
Sodium level 126-130 mmol/L
Severe SIADH:
Related to cerebral edema
Ataxia
Hypoactive reflexes
Sodium level less than 120 mmol/L
SIADH Labs - ✔✔Sodium: decreased
Urine specific gravity increased
, SIADH treatment - ✔✔-Fluid restriction
-Treat any underlying malignancy (or other cause).
Systemic Inflammatory Response Syndrome(SIRS) - ✔✔Two or more of any of the following
signs and symptoms:
-Temperature: > 38C (100.4F) or less than 36C (96.8F)
-HR > 90 beats per minute
-RR > 20 breaths per minute or PaCO2 less than 32 mmHg
-WBC > 12,000 mm3, less than 4,000 mm3, or greater than 10% bands
SIRS - ✔✔-Antibiotic therapy
-Glucose management
-Supplemental oxygen
-Consultations with other specialties (e.g., cardiology, gastroenterology); dependent on the
causative factor.
Tumor Lysis Syndrome Signs and Symptoms - ✔✔Initial:
-Nausea and vomiting
-Abdominal pain or distention
-Dyspnea
-Edema
-Muscle or joint pain, muscle twitching
Progressive:
-Oliguria, hematuria, azotemia; progressing to anuria
-Congestive heart failure: Hypertension, then tachycardia, then bradycardia, progressing to
ventricular arrhythmias
-Progressive muscle weakness, paresthesias, tetany, seizures
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