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Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Hypernatremia Diagnosis ... Workup Step 1 ... mmol/L - true hyponatremia ... EUVOLEMIC • SIADH ... renal failure #Hypernatremia
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... water retention 1) ... Low Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia ... #nephrology #sodium
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... irrigants Hypotonic Hyponatremia ... OFF (UNa > 30): SIADH ... SatyaPatelMD #Hyponatremia
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Inappropriate - Consider: SIADH ... @NephroMD #hyponatremia ... #causes #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... 1) Check Urine ... Extrarenal Hypernatremia ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
Hyponatremia - Diagnostic ... Evaluation Algorithm ... Step 1: Consider ... tests Step 5: If SIADH ... DrEricStrong #Hyponatremia
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Salt Wasting vs SIADH ... Pathophysiology 1) ... #SaltWasting #SIADH ... Pathophysiology #diagnosis #nephrology ... #hyponatremia #
Hyponatremia Treatment Algorithm CHF, Cirrhosis - Fluid restriction SIADH - Fluid restriction - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... Fluid restriction SIADH ... water diuresis) 1° ... DrEricStrong #Hyponatremia
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... insufficiency, SIADH ... thecurbsiders #Hyponatremia ... #causes #nephrology
Causes of Secondary / Provoked Seizures - Differential Diagnosis Algorithm Febrile Infection • Sepsis • Encephalitis • Meningitis Metabolic
Differential Diagnosis Algorithm ... Hypocalcemia • Hyponatremia ... • Conversion Disorder ... Provoked #Seizures #Neurology ... Differential #Diagnosis #Algorithm
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