16 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... EUVOLEMIC • SIADH ... • nephrotic syndrome ... Diagnosis #Workup #Algorithm ... #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... treat underlying cause ... cirrhosis, nephrotic syndrome ... , SSRIs) - SIADH ... #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH ... #Algorithm #diagnosis ... #sodium #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Diagnosis Workup Algorithm ... insipidus (central or nephrogenic ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... #nephrology #sodium
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Tea and Toast Syndrome ... insufficiency, SIADH ... #causes #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... Cirrhosis, Nephrotic syndrome ... #algorithm #diagnosis ... #sodium #low #nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... , Renal Sodium loss ... Cirrhosis, Nephrotic syndrome ... #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... • Euvolemia: SIADH ... Cirrhosis, Nephrotic Syndrome ... #diagnosis #causes ... #nephrology #sodium
Management of SIADH
Treat underlying cause:
 • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... promoting passive sodium ... SatyaPatelMD #SIADH ... #Management #hyponatremia ... #nephrology #treatment
SIADH Treatment Options
1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... Treat underlying cause ... promoting passive sodium ... #Management #hyponatremia ... #nephrology #treatment