136 results
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia: • Hypovolemic ... Skin loss • Euvolemic ... access to H2O • Hypervolemic ... Hypernatremia: • Hypovolemic ... ) diuresis • Euvolemic
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
uric acid high in hypovolemic ... and hypervolemic ... uric acid low in euvolemic
Differential Diagnosis and Evaluation of Hyponatremia:
1) Identification of onset (acute vs. chronic)
2) Presence of symptoms (HA,
#Hyponatremia #Hypovolemic ... #Euvolemic #Hypervolemic
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Dependent: • Hypovolemic ... • Euvolemic ... • Hypervolemic
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
to Hyponatremia Hypovolemic ... Cerebral salt wasting Euvolemic ... Primary polydipsia Hypervolemic
POCUS Echocardiogram Volume Assessment

Echo provides increased accuracy and insight into volume state assessment. This grid illustrates
systolic failure - A hypovolaemic ... recent echo while euvolemic ... Diagnosis #Comparison #Hypovolemic ... #Hypervolemic #
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm Hypovolemic ... - Give volume Hypervolemic ... nephrotic syndrome) Euvolemic
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
HYPOVOLEMIC • ... - diuretics EUVOLEMIC ... psychogenic polydipsia HYPERVOLEMIC
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Diagnosis Algorithm Hypovolemia ... wasting syndrome Hypovolemia ... Pancreatitis, Trauma Euvolemia
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Inappropriate ADH - Euvolemic ... Malignancy True hypovolemia