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diagnosis nephrology algorithm differential hyponatremia pathophysiology table anticoagulation bulimianervosa causes chloride citrate complications dermatomes diuresis diuretics excretion extremity gitelman hypokalemia
Mechanisms of nephron damage in cardiorenal syndrome • Increased renal interstitial pressure • Hypoperfusion • Reduced
nephron damage in cardiorenal ... syndrome • Increased ... Reduced renal blood flow ... hypertrophy • Sodium ... pathophysiology #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
• Euvolemic (Low ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Workup #Algorithm #nephrology ... #sodium
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Modified Hyponatremia ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia, Low ... Algorithm #diagnosis #sodium ... #nephrology
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Based Approach to Hyponatremia ... Hypothyroidism, Low ... Cirrhosis, Nephrotic syndrome ... algorithm #diagnosis #sodium ... #low #nephrology
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
• Normal/low ... diuretic use, Bartter syndrome ... , Gitelman syndrome ... settings, the urine sodium ... the excretion of sodium
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
: SIADH, Renal Sodium ... can be high or low ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia), Low ... #nephrology
Lower Extremity Dermatomes and Myotomes Reflexes: • Knee - L2, L3, L4 • Ankle - S1
and Myotomes Reflexes ... • Cauda Equina Syndrome ... - Low back pain ... dysaesthesia, neurogenic ... Myotomes #diagnosis #neurology
Diuretics and Agents Regulating Renal Excretion Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide) • Glaucoma • Epilepsy • Altitude
• Metabolic alkalosis ... • Hyponatremia ... • Nephrogenic ... and euvolemic hyponatremia ... Excretion #Diuresis #Nephrology
Hyponatremia - Differential Algorithm Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP Hypotonic Hyponatremia: • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... Algorithm Isotonic Hyponatremia ... Cirrhosis, Nephrotic Syndrome ... diagnosis #causes #nephrology ... #sodium #low
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
thiazide-sensitive sodium ... thiazide-sensitive sodium ... • Normal or low ... Hypochloremic metabolic alkalosis ... #diagnosis #nephrology
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