8 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Workup Step 1 ... Repeat the sodium ... Step 2. ... - diuretics EUVOLEMIC ... #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... 1) Check Urine ... renal mechanism 2) ... Skin loss • Euvolemic ... #nephrology #sodium
Differential Diagnosis and Evaluation of Hyponatremia:
1) Identification of onset (acute vs. chronic)
2) Presence of symptoms (HA,
Diagnosis and Evaluation ... : 1) Identification ... acute vs. chronic) 2) ... history #Diagnosis #EM ... #Hypovolemic #Euvolemic
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Hypovolemic, Serum ... Cerebral salt wasting Euvolemic ... uric acid <4 • SIADH ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... nephrotic syndrome) Euvolemic ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Pancreatitis • Euvolemia ... : SIADH, Beer Potomania ... polydipsia • Hypervolemia ... MH/CCF/CWRU EM ... #sodium #low
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Diagnosis Algorithm ... water retention 1) ... Serum Osmolarity 2) ... Low Uric Acid → SIADH ... #nephrology #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... +K / serum Na >1 ... , Renal Sodium loss ... : Hypovolemia, Hypervolemia ... #nephrology