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diagnosis differential management algorithm sodium causes neurology hyperkalemia hypokalemia low barre gitelman guillain high table urine alkalosis apex cancer chloride
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... EUVOLEMIC • SIADH ... • nephrotic syndrome ... Workup #Algorithm #Nephrology
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
Modified Hyponatremia ... Algorithm Hypertonic Hyponatremia ... Cirrhosis, Nephrotic syndrome ... OFF (UNa > 30): SIADH ... diagnosis #sodium #nephrology
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Tea and Toast Syndrome ... insufficiency, SIADH ... failure, nephrotic syndrome ... Algorithm #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 ... SatyaPatelMD #Volume #Hyponatremia ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... cirrhosis, nephrotic syndrome ... , SSRIs) - SIADH ... UnremarkableLab #Hyponatremia ... Algorithm #diagnosis #nephrology
Hypokalemia Differential Diagnosis Algorithm Hypertensive: • High Al, Low R - Primary aldosteronism • High Al, High
acid, Liddle's Syndrome ... R - Cushing's syndrome ... , Gitelman's syndrome ... Diagnosis #Algorithm #nephrology ... #causes #low #potassium
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... underlying cause of SIADH ... restriction • All ... #Management #hyponatremia ... #nephrology #treatment
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... restriction alone in SIADH ... Present (Uosm ≥100): SIADH ... Cirrhosis, Nephrotic syndrome ... table #sodium #nephrology
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... Start with 1g NaCl ... SatyaPatelMD #SIADH ... #Management #hyponatremia ... #nephrology #treatment
Management of Hyponatremia Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125 Give
Management of Hyponatremia ... Normalizes in SIADH ... • IF SIADH — ... give specific treatment ... Wilkinsonjonny #Hyponatremia
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