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Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Hypernatremia Diagnosis ... Step 2. ... mmol/L - true hyponatremia ... EUVOLEMIC • SIADH ... renal failure #Hypernatremia
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ADH ... ADH Dependent: ... insufficiency, SIADH ... thecurbsiders #Hyponatremia
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... irrigants Hypotonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Utilizing Uric Acid ADH ... Serum Osmolarity 2) ... Low Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... cirrhosis, nephrotic syndrome ... • UOsm > 300 - ADH ... , SSRIs) - SIADH ... UnremarkableLab #Hyponatremia
Causes of Hyponatremia - Differential Diagnosis Algorithm Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... - Differential ... Pain/Post-op • Neurologic ... osmole intake #Hyponatremia ... #Nephrology #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... - Differential ... Pain/Post-op • Neurologic ... osmole intake #Hyponatremia ... #Nephrology #Differential
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) ... Hypovolaemia → ADH ... #SaltWasting #SIADH ... #hyponatremia #
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... case of hypotonic hyponatremia ... Cirrhosis, Nephrotic syndrome ... Physiologic #Hypotonic #Hyponatremia ... #differential #
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... renal mechanism 2) ... Extrarenal Hypernatremia ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia
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