9 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Workup Step 1 ... Step 2. ... mmol/L - true hyponatremia ... renal failure #Hypernatremia
Cerebral Salt Wasting vs SIADH - Pathophysiology 
1) Neurological event
2) Sodium loss from tubules
3) Naturiesis →
Pathophysiology 1) ... Neurological event 2) ... Sodium loss from ... #hyponatremia # ... comparison
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... water retention 1) ... Serum Osmolarity 2) ... Low Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia ... #sodium
Hypernatremia - Differential Diagnosis and Treatment
Hypernatremia is almost always due to unreplaced water loss (free water
Hypernatremia - ... and Treatment Hypernatremia ... Treatment of hypernatremia ... @EmmGeezee #Hypernatremia ... #sodium
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
Options 1. ... Basically anything 2. ... purposes, restrict to 1 ... promoting passive sodium ... #Management #hyponatremia
DDAVP Clamp Protocol in Hyponatremia
 • Stop any maintenance fluids.
 • Start DDAVP 2 mcg IV
DDAVP Clamp Protocol ... in Hyponatremia ... • Start DDAVP 2 ... Start 3% NaCl (1- ... #Protocol #Hyponatremia
Primary Polydipsia
Definition: Excessive volitional water intake
Epidemiology:
 • 6-20% of patients with psychiatric disorders - Most commonly
• Symptomatic hyponatremia ... occurs in only 2- ... with symptomatic hyponatremia ... Pseudohyponatremia, SIADH ... , Urine Sodium
Hyponatremia Differential Diagnosis Algorithm in Cancer
UOsm ≥ 100 mOsm/kg = Urine is inappropriately concentrated for hypotonic
Hyponatremia Differential ... CAR-T- and IL-2- ... inappropriate • SIAD ... adrenalitis; PD-1 ... metastases) #Hyponatremia