Urine without flavor. That is the literal meaning of the term diabetes insipidus
ID: 96576 • Letter: U
Question
Urine without flavor. That is the literal meaning of the term diabetes insipidus, a disorder in which the mechanism that concentrates urine is inadequate or absent. The main symptoms of this rare disease are intense thirst and copious excretion of dilute urine. (A) Why does this disease produce each of these symptoms? (you must explain the mechanism for both thirst and increased urine production) (B) Explain why a traumatic head injury may cause this disease. (C) How is this disease similar to diabetes mellitus? How is it different? A lactose-intolerant subject couldn't resist consuming a pint of Ben & Jerry's ice cream. Within hours, this individual developed diarrhea and a severe case of flatulence. (A) What is lactose intolerance? (B) Given your understanding of this condition, explain how eating ice cream would result in the described symptoms. (C) Describe the changes in fluid osmolarity and acid-base balance that might accompany this condition. Two normally hydrated subjects ingest the following: (A) 1 Liter of beer (assume it is isotonic) (B) 1 Bucket of heavily salted popcorn For each indicate how body fluid volume and body fluid osmolarity will change. Then describe how urine flow rate and urine concentration will change over the following two hours in each case. (You have to discuss the mechanism behind the observed changes-which hormones, receptors etc. are involved.)Explanation / Answer
4. (A) Diabetes insipidus occurs when the body has a lower than normal amount of antidiuretic hormone (ADH) or vasopressin. ADH controls the amount of water excreted in urine. Without ADH, the kidneys do not work properly to keep enough water in the body. The result is a rapid loss of water from the body in the form of dilute urine. This causes excessive urination in diabetes insipidus. This excessive urination results in the need to drink large amounts of water due to extreme thirst and to make up for excessive water loss in the urine (as much as 4 gallons or 15 liters a day).
(B) Diabetes insipidus (DI) results from decreased secretion and action of anti-diuretic hormone (ADH) which is produced in the hypothalamus and transported to the posterior pituitary gland.
In a head injured patient decreased production and secretion of ADH can result from:
1. Direct disruption of the hypothalamus or pituitary
2. Interruption of the blood supply to these parts of the brain
3. Increased ICP or oedema causing herniation of the brain and subsequent compression of the pituitary stalk or gland
In this way, the traumatic head injury can lead to dysfunction of the hypothalamic neurons which secretes antidiuretic hormone (ADH) or of the posterior pituitary gland which causes post-traumatic diabetes incipidus (PTDI). PTDI is usually diagnosed in the first days after the trauma presenting with hypotonic polyuria.
(C) Similarities : Diabetes insipidus and diabetes mellitus share similar signs and symptoms, like excessive thirst and excessive urination.
Differences :
Diabetes Mellitus
Diabetes Incipidus
1. It is a pancreatic disorder.
1. It is a hypothalamic disorder.
2. It is due to deficiency of insulin availability of cell.
2. It is caused by deficiency of ADH.
3. There is rise in blood glucose level or hyperglycemia.
3. No rise in blood sugar level.
4. Glucose is excreted along with urine.
4. Glucose is not excreated.
5. The urine is normal concentration.
5. The urine is very dilute.
6. Blood cholesterol level often rises.
6. Blood cholesterol level does not rise normally.
7. There is excessive eating.
7. Hunger is normal.
8. Ketone bodies ocur in blood and urine.
8. In this case they do not occur.
5. (A) Lactose intolerance means the body cannot easily digest lactose, a type of natural sugar found in milk and dairy products. When lactose moves through the large intestine (colon) without being properly digested, it can cause uncomfortable symptoms such as gas, belly pain, and bloating. Some people who have lactose intolerance cannot digest any milk products.
(B) As ice cream contain lactose and lots of fat, so the person who suffers from lactose intolerance will not be able the lactose part of ice cream. Because, in case of lactose intolerance lactase, which is necessary for digest or absorb lactose, does not secrete from small intestine.
(C) In this case as poorly absorbed, osmotically active substance (lactose) is ingested it leads to diarrhoea. Due to this, excessive amounts of water and electrolytes are lost which causes osmotic imbalance.
Diabetes Mellitus
Diabetes Incipidus
1. It is a pancreatic disorder.
1. It is a hypothalamic disorder.
2. It is due to deficiency of insulin availability of cell.
2. It is caused by deficiency of ADH.
3. There is rise in blood glucose level or hyperglycemia.
3. No rise in blood sugar level.
4. Glucose is excreted along with urine.
4. Glucose is not excreated.
5. The urine is normal concentration.
5. The urine is very dilute.
6. Blood cholesterol level often rises.
6. Blood cholesterol level does not rise normally.
7. There is excessive eating.
7. Hunger is normal.
8. Ketone bodies ocur in blood and urine.
8. In this case they do not occur.
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