One Stem at a Time: High-Yield Board Review for Medical Students

Water Wars: DI vs SIADH

15 min · 9. apr. 2026
episode Water Wars: DI vs SIADH cover

Beskrivelse

Struggling to tell DI vs SIADH apart on test day? This episode breaks it down step-by-step—starting with a classic USMLE-style question and ending with the high-yield patterns you need to answer fast and confidently. We kick things off with a patient presenting with polyuria, polydipsia, hypernatremia, and dilute urine after starting a mood stabilizer—can you identify the diagnosis and next best step? From there, we walk through the full framework for approaching water balance disorders. In this episode, you’ll learn: • How to interpret serum vs urine osmolality like a pro • The key differences between central vs nephrogenic diabetes insipidus • Why desmopressin response is the ultimate diagnostic clue • The mechanism behind lithium-induced nephrogenic DI (and why amiloride is the answer) • A clear, test-day comparison of DI vs SIADH • High-yield treatment strategies you’ll see on Step 2

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