10-04-2010, 07:33 AM
How to diirentiate Bartter's syndrome from the use of loop diuretics??
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Bartter's syndrome? - norwood
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10-04-2010, 08:05 AM
Bartter sign is like who use lasix and just with measuring diuritic in urine we can differenciated.
10-04-2010, 08:51 AM
Bartter syndrome is a rare inherited defect in the thick ascending limb of the loop of Henle. It is characterized by low potassium levels (hypokalemia), decreased acidity of blood (alkalosis), and normal to low blood pressure.
People suffering from Bartter syndrome present symptoms which are identical to those of patients who are on loop diuretics like furosemide. The clinical findings characteristic of Bartter syndrome are hypokalemia, metabolic alkalosis, and normal to low blood pressure. These findings may also be caused by: Chronic vomiting: These patients will also have low urine chloride levels Abuse of diuretic medications (water pills): The physician must screen urine for multiple diuretics before diagnosis is made. Magnesium deficiency: These patients will also have low serum and urine magnesium
10-04-2010, 09:56 AM
A 32 year old Female came to ED with weakness,tingling,numbness of extremities. she is not on any medication.
On phsical exam  R-90,RR-14,BP-110/70Labs value are : Blood PH-7.56 Serum Na -135 K-2.9 Cl-92 BUN-22 S.creatinine-0.9 bicarb-37 urine Na-16 urine K-20 urine Cl-7 Magnesiun level came back after 1 day and shows value between normal range Most likely cause of this patients condition is? a.surreptitious vomiting b.Acute Renal Failure c. Gitelmans syndrome d .Bartters Syndrome e .Hyperventilation f. Liddle syndrome Liddle syndrome is a defect in sodium absorption where excess amount of sodium is absorbed it is autosomal recessive CF hypertension present since childhood LAB increased sodium , decreased potassium, decreased renin ,decreased aldosterone Rx potassium sparing diuretics like triamterene and amiloride remember not to give spiranolactone becuse defect in liddles syndrome is defect on epithelial transport and is independant on aldosterone Barter syndrome there is defect in loop of henle and findings are same that are seen with use of loop diuretics it is also familial sodium potassium magnesium wasting present BP is normal calcium is low renin and aldosterone are high causes chloride resistant metabolic alkalosis treat with potassium supplementation clinically it may present with polyuria and polydipsia because hypokalemia causes nephrogenic diabetes insipidus Hypokalemia and Metabolic alkalosis -------> Bartter, Gitelman & Liddle's syndrome Bartter & Gitelman -----> Normal/dec BP Liddle's ---------> Inc BP Bartter ------> Normal Mg Gitelman ------> dec Mg Treatment: Bartter: Inc salt diet, Inc K, NSAIDS Gitelman: Inc K, Inc Mg, Amiloride Liddle's :Amiloride use of loop diuretics
10-04-2010, 10:12 AM
use of loop diuretics
BP HIGH OR NORMAL K LOW ncreased urinary magnesium excretion INCREASE CA IN URINE patients with serum uric acid levels ≥ 4 mg/d were consistent with [DEHYDRATION] extracellular volume depletion. Barter syndrome there is defect in loop of henle and findings are same that are seen with use of loop diuretics it is also familial sodium potassium wasting present MG quite NORMAL BP is normal CALCIUM is low renin and aldosterone are high causes chloride resistant metabolic alkalosis treat with potassium supplementation clinically it may present with polyuria and polydipsia because hypokalemia causes nephrogenic diabetes insipidus |
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