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diagnosis nephrology differential causes workup management hypernatremia low treatment obgyn table adh cancer cerebral comparison cushings ebv endocrinology evaluation hypercortisolism
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... → Increased urine ... #SaltWasting #SIADH ... diagnosis #nephrology #hyponatremia
True Hyponatremia Differential Algorithm Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... sodium and serum ... acid high in hypovolemic ... - Urine sodium ... #Differential #Algorithm
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Sodium 4) Serum ... Low Uric Acid → SIADH ... #nephrology #sodium
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Based Approach to Hyponatremia ... Hypovolemic, Serum ... uric acid <4 • SIADH ... #algorithm #diagnosis ... #sodium #low #nephrology
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Algorithm Hypertonic ... ON (UNa < 30): Hypovolemia ... OFF (UNa > 30): SIADH ... #Algorithm #diagnosis ... #sodium #nephrology
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... Urine Na+K / serum ... restriction alone in SIADH ... , Renal Sodium loss ... , Hypervolemia with
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... HYPOVOLEMIC • ... EUVOLEMIC • SIADH ... Diagnosis #Workup #Algorithm
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... : • Hypovolemia ... • Euvolemia: SIADH ... polydipsia • Hypervolemia ... causes #nephrology #sodium
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... Hypovolemic - Give ... , SSRIs) - SIADH ... diagnosis #nephrology #sodium
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... EABV) - Consider: Hypovolemia ... Inappropriate - Consider: SIADH ... #differential #algorithm
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