13 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... volume loss - diarrhea ... renal failure #Hypernatremia ... #Algorithm #Nephrology
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
Causes of Hypernatremia ... Hypernatremia ... mannitol, glucosuria Low ... loss • Watery Diarrhea ... Hyperventilation #Hypernatremia
Diagnostic Approach to Hyponatremia
Box A:
 • Normo/hyperosmolar Hyponatremia: Glucose, Mannitol, Glycine, Contrast media, Maltose
 • Pseudohyponatremia:
Diagnostic Approach to Hyponatremia ... Normo/hyperosmolar Hyponatremia ... Primary Polydipsia, Low ... Wilkinsonjonny #Hyponatremia ... #workup
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... • Euvolemic (Low ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Primary polydipsia, Low ... @NephroMD #hyponatremia ... #causes #nephrology
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Hyponatremia - Diagnostic ... Evaluation Algorithm ... considered likely, the cause ... DrEricStrong #Hyponatremia ... #Diagnosis #Workup
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Beer Potomania - Low ... thecurbsiders #Hyponatremia ... #causes #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... losses, Vomiting, Diarrhea ... Cardiac failure #Hyponatremia ... #Causes #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... Hyponatremia: Hyperlipidemia ... TURP Hypotonic Hyponatremia ... #diagnosis #causes ... nephrology #sodium #low
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis Algorithm ... Weakness, fatigue, nausea ... , hypotension, hyponatremia ... Baseline plasma ACTH Low ... insufficiency • Low