18 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Workup Step 1 ... mmol/L - true hyponatremia ... failure #Hypernatremia ... #Nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... syndrome - ... OFF (UNa > 30): SIADH ... #sodium #nephrology
Nephritic vs Nephrotic Syndrome

Step 1: If the patient has hematuria and/or proteinuria, think about nephrotic/nephritic syndromes.
Step
1: If the patient ... /nephritic syndromes ... hematuria (RBC casts ... #Syndrome #Comparison ... #Algorithm #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... syndrome) Euvolemic ... UnremarkableLab #Hyponatremia ... #diagnosis #nephrology ... #sodium
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... water retention 1) ... Low Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia ... #nephrology #sodium
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... insufficiency, SIADH ... liver failure, nephrotic ... thecurbsiders #Hyponatremia ... #causes #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... syndrome • Urine ... SatyaPatelMD #Volume #Hyponatremia ... #sodium #low #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... • Euvolemia: SIADH ... Syndrome, Chronic ... #diagnosis #causes ... #nephrology #sodium
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Pathophysiology 1) ... Neurological event 2) Sodium ... Pathophysiology #diagnosis #nephrology ... #hyponatremia # ... comparison
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... of hypotonic hyponatremia ... +K / serum Na >1 ... Physiologic #Hypotonic #Hyponatremia ... #nephrology