82 results
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... • Euvolemic (Low ... , Cushing syndrome ... #Differential #Diagnosis ... Algorithm #nephrology #sodium
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
acid: - Urine sodium ... low, uric acid ... - Urine sodium ... and uric acid low ... Differential #Algorithm #Diagnosis
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... - Differential Diagnosis ... insipidus • Nephrogenic ... #Differential #Diagnosis ... Causes #nephrology #sodium
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Osmolarity 3) Urine Sodium ... Uric Acid - Low ... #low #uricacid
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... • nephrotic syndrome ... #Diagnosis #Workup
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
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
- Differential Diagnosis ... Normal Acid-Base: Low ... • Metabolic acidosis ... • Metabolic acidosis ... #Differential #Diagnosis
Inherited Defects in Kidney Tubule Epithelial Cells

Renal glucosuria - Na+-dependent glucose cotransporter
Cystinuria - Amino acid transporter
Bartter
cell epithelial sodium ... of epithelial sodium ... renal tubular acidosis ... -2 deficiency Nephrogenic ... Kidney #Nephrology #Diagnosis
Diagnostic Approach to Hyponatremia
Box A:
 • Normo/hyperosmolar Hyponatremia: Glucose, Mannitol, Glycine, Contrast media, Maltose
 • Pseudohyponatremia:
Diagnostic Approach ... to Hyponatremia ... 8, Somnolence, Seizures ... Primary Polydipsia, Low ... #Diagnosis #Algorithm
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