7 results
Differential Diagnosis and Evaluation of Hyponatremia:
1) Identification of onset (acute vs. chronic)
2) Presence of symptoms (HA,
: 1) Identification ... nausea, confusion, seizures ... ) 3) Assessment ... history #Diagnosis #EM ... #Hypovolemic #Euvolemic
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Diagnosis Algorithm ... water retention 1) ... Urine Osmolarity 3) ... Urine Sodium 4) ... #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... 1) Check Urine ... Skin loss • Euvolemic ... (Low H2O intake ... #nephrology #sodium
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Workup Step 1 ... Repeat the sodium ... administration Step 3. ... - diuretics EUVOLEMIC ... Diagnosis #Workup #Algorithm
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... : • Hypovolemia ... Pancreatitis • Euvolemia ... MH/CCF/CWRU EM ... #sodium #low
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 ... can be high or low ... Present (Uosm ≥100): Hypovolemia ... #nephrology
Citrate Anticoagulation Toxicity

Hypernatremia (HyperNa):
 - Citrate solutions may have ↑ sodium content and should be paired
Anticoagulation Toxicity Hypernatremia ... circulation → ↓Mg Hypocalcemia ... dysfunction or low ... accumulate as: - 1 ... Citrate → 3 HCO3