6 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... • SIADH • hypothyroidism ... #Diagnosis #Workup ... #Algorithm #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Algorithm 1) ... mechanism 2) Volume ... Diuretics, osmotic (solute ... #sodium
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
to Hyponatremia ... acid <4 • SIADH, Hypothyroidism ... , Low solute intake ... algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... Hypovolemic - Give volume ... 200 - Inadequate Solute ... CKD, Thiazides, Hypothyroidism ... diagnosis #nephrology #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Medications (diuretics), Hypothyroidism ... polydipsia, Low solute ... #Algorithm #diagnosis ... #sodium #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
algorithm Urine ... : SIADH, Renal Sodium ... or low Uosm), Hypothyroidism ... little relative solute ... polydipsia), Low solute