26 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... EUVOLEMIC • SIADH ... • nephrotic syndrome ... #Algorithm #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Hypervolemic: Conn syndrome ... , Cushing syndrome ... #Algorithm #nephrology ... #sodium
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... insipidus • Nephrogenic ... administration #Hypernatremia ... Differential #Diagnosis #Causes ... #nephrology #sodium
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... treat underlying cause ... cirrhosis, nephrotic syndrome ... , SSRIs) - SIADH ... #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH ... Algorithm #diagnosis #sodium ... #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 ... restriction alone in SIADH ... , Renal Sodium loss ... Cirrhosis, Nephrotic syndrome ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Tea and Toast Syndrome ... insufficiency, SIADH ... Diagnosis #Algorithm #causes ... #nephrology
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
Hyponatremia - Differential ... - Cirrhosis Syndrome ... ADH secretion (SIADH ... Diagnosis #Table #Causes ... #Sodium
Causes of Seizures - Differential Diagnosis Algorithm
Unprovoked - Epilepsy:
 • Focal: Simple, Complex
 • Generalized: Absence,
Causes of Seizures ... vasoconstriction syndrome ... Hyperglycemia, Hyponatremia ... Diagnosis #Algorithm #Causes ... #neurology