Primary polydipsia Alcoholism may cause physiological thirst since ethanol inhibits vasopressin, the hormone primarily responsible for water retention in osmoregulation. The following conditions should also be excluded: DI, cerebral salt wasting, pseudohyponatraemia caused by hyperlipidemia or hyperparaproteinemia, SIADH, mineralcorticoid deficiency, salt-wasting nephropathy, nephrotic syndrome, chronic heart failure and cirrhosis. Tobacco smoking is an often overlooked factor linked to hyponatremia, due to the ADH-releasing effect of nicotine, although this is usually limited to heavy smokers. One study suggested that around 70% of patients with self-induced polydipsia were tobacco smokers. Diagnostic tests for primary polydipsia usually involves the fluid deprivation test to exclude ADH
Medical school based on lectures, simulations, standardized-patient sessions, problem-based learning sessions, seminars, and observational clinical experiences. By year three, most schools have begun the non-elective, clinical-rotation block with accompanying academic courses (these include but are not limited to internal medicine, pediatrics, general surgery, anaesthesiology, orthopaedics, gynaecology and obstetrics, emergency medicine, neurology, psychiatry, oncology, urology, physical medicine and rehabilitation, ophthalmology, and otorhinolaryngology). Elective rotations are usually introduced in the fourth or fifth year, though as in the case of the non-elective rotations, "the hospitals the medical students may be placed in or apply to for a given rotation depend entirely on the medical