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Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Consider: Primary polydipsia ... , Low solute intake
Diagnostic Approach to Hyponatremia Box A: • Normo/hyperosmolar Hyponatremia: Glucose, Mannitol, Glycine, Contrast media, Maltose • Pseudohyponatremia:
Box C: Primary Polydipsia ... , Low Na intake,
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Hypothyroidism, Low ... deficiency, Primary polydipsia ... diagnosis #sodium #low
Causes of Polyuria - Differential Diagnosis Excess Intake of Water: • Primary polydipsia (a.k.a. "psychogenic polydipsia") •
Water: • Primary polydipsia ... "psychogenic polydipsia ... • Central Dl (Low
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
Beer Potomania - Low ... • Psychogenic Polydipsia
Hypoxia and Hypoxemia - Overview Hypoxia - insufficient oxygen delivered to tissues to meet demands Hypoxemia - low
demands Hypoxemia - low ... of hypoxia) - Low ... SvO2 → Low PaO2 ... COHb, MetHb) - Low ... CaO2 → Low SvO2
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
100): Primary polydipsia ... , Low solute intake
Polyuria - Differential Diagnosis Algorithm Polyuria = >3L Urine output / 24 hours Urine osmolality = 2 (Na
nutrition), Azotemia LOW ... Insipidus • Primary Polydipsia
Increased Urination - Differential Diagnosis Framework - Increased Volume / Frequency • Increased osmotic load (Increased
urine (usually low ... Increased intake (low ... osm): Primary Polydipsia
Severe Mitral Stenosis- The physical examination revealed a right parasternal heave, a loud S1, a midpeaking
border, and a low-pitched ... 0.5 cm2) (see video ... Color-flow Doppler ... The slow decline ... see source for video
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