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diagnosis differential nephrology algorithm causes lactate alkalosis chloride classification criticalcare defects elevation epithelial gitelman heat heatstroke hypokalemia hyponatremia hypotonic illness
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
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 ... #Differential #Table
Lactic Acidosis - Differential Diagnosis Framework Type A: Impaired O2 Delivery (DO2) • Decreased O2 Delivery: Hypotension
Lactic Acidosis ... Ischemia, Compartment Syndrome ... Hypothermia & Shivering, Seizures ... toxic alcohols, Sodium ... in Short Bowel Syndrome
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
alkalosis • Normal/low ... diuretic use, Bartter syndrome ... , Gitelman syndrome ... ketoacidosis • D-lactic ... 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 ... differential #diagnosis #table ... #sodium #nephrology
Heat Illnesses and Heat Stroke - Differential Diagnosis Framework Heat Cramps: • Muscle pain or spasm -
Dehydration - Loss of sodium ... conditions - Neurogenic ... heat illness → Hypernatremia ... consciousness, Coma/seizure ... Possible DIC - Mild lactic
Causes of Lactate Elevation, Lactic Acidosis - Differential Diagnosis The most common causes of hyperlactatemia are usually:
Lactate Elevation, Lactic ... circulation If drugs, seizures ... Heavy exercise - Seizures ... LV failure - Low ... - Compartment syndrome
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 ... alkalosis • Normal or low ... Renal tubular acidosis ... tachycardia • Seizures
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