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diagnosis differential nephrology refeeding signs symptoms algorithm beriberi bulimianervosa causes complications deficiency gitelman heat heatstroke hypokalemia icucard illness korsakoff management
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
• Euvolemic (Low ... insipidus (central or nephrogenic ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... Algorithm #nephrology #sodium
Refeeding Syndrome: Pathogenesis and clinical findings Patients at Risk of Refeeding Syndrome: - Little or no nutritional
- Little or no nutritional ... weight loss - Low ... disturbances: low ... - Metabolic Acidosis ... #diagnosis #pathophysiology
Refeeding Syndrome Overview What Is It? • Electrolyte/fluid shifts caused by initiation of nutrition in severely malnourished patient.
initiation of nutrition ... Rhabdomyolysis • Seizures ... , K, Mg2+) • Slow ... #Nutrition #Differential ... #Diagnosis #Pathophysiology
Heat Illnesses and Heat Stroke - Differential Diagnosis Framework Heat Cramps: • Muscle pain or spasm -
Dehydration - Loss of sodium ... conditions - Neurogenic ... heat illness → Hypernatremia ... Collapse: • Pathophysiology ... consciousness, Coma/seizure
Thiamine Deficiency - Differential Diagnosis Framework and Clinical Manifestations Causes of Thiamine Deficiency: • Poor intake: - Diets
- Refeeding syndrome ... rice, Cereals • Low ... seen • Lactic acidosis ... #beriberi #nutrition ... #pathophysiology
Gitelman Syndrome Overview What? • Inherited (AR) hypokalemic salt-losing tubulopathies affecting the thiazide-sensitive sodium chloride cotransporter • Gitelman's syndrome
thiazide-sensitive sodium ... alkalosis • Normal or low ... Renal tubular acidosis ... tachycardia • Seizures ... nephrology #management #pathophysiology
#ICUCard RENAL GFR 90-131 mL/min ((140-age)*Wt)/(72*Cr) Glomerular Filtration Rate (Cockcroft) CI Cr 90-131 mL/min (CrU * volume)/CrS Creatinine Clearance FENa 0.0-1.0 % ((U/P Na)/(U/P Cr))*100 Fractional Excretion of Na+ Na req mEq (125-Na)*0.6*Wt Required Sodium FE Urea
0.6*Wt Required Sodium ... 9 Respiratory Acidosis ... base Equation NUTRITION ... Distress Syndrome ... Bicarbonate, Sodium
Bulimia Nervosa: Complications GASTROINTESTINAL • Dehydration & inability to digest food -> Constipation • Recurrent vomiting exposes
• Boerhaave syndrome ... hormonal imbalances (low ... lead to metabolic acidosis ... hypochloremia, hypernatremia ... Complications #pathophysiology
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