16 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... and Workup Step ... hypothyroidism • adrenal ... #Diagnosis #Workup ... #Algorithm #Nephrology
Diagnostic Approach to Hyponatremia
Box A:
 • Normo/hyperosmolar Hyponatremia: Glucose, Mannitol, Glycine, Contrast media, Maltose
 • Pseudohyponatremia:
Diagnostic Approach ... Somnolence, Seizures, Confusion ... Primary Polydipsia, Low ... #Diagnosis #Algorithm ... #workup
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... Workup Algorithm ... • Euvolemic (Low ... #Workup #Algorithm ... #nephrology #sodium
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis ... Algorithm Clinical ... , hypotension, hyponatremia ... insufficiency • Low ... #Algorithm #endocrinology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Beer Potomania - Low ... Hypothyroidism, adrenal ... #nephrology
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Uric Acid - Low ... High Uric Acid → renal ... #Algorithm #nephrology
Differential Diagnosis and Evaluation of Hyponatremia:
1) Identification of onset (acute vs. chronic)
2) Presence of symptoms (HA,
and Evaluation ... of Hyponatremia: ... symptoms (HA, nausea, confusion ... cardiac, liver, renal ... #Differential #Algorithm
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Hypothyroidism, Adrenal ... Primary polydipsia, Low ... #Algorithm #diagnosis ... #sodium #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Primary polydipsia, Low ... solute intake, Renal ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Hypothyroidism, Low ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology