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
Perioperative medicine Perioperative medicine Perioperative medicine is the medical care of patients from the time of contemplation of surgery through the operative period to full recovery, but excludes the operation or procedure itself. Perioperative care may be provided by an anesthesiologist, Intensivist, an internal medicine generalist or hospitalist working with surgical colleagues. Perioperative medicine encompasses the care of the patient preparing for, having and recuperating from surgery. In the practice of perioperative medicine the surgeon, anesthesiologist, intensivist and medical consultant work in concert. The medical knowledge distinct to this field includes that of operative risk and complications, of patient specific risks, of