19 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... liver failure • nephrotic ... syndrome • renal ... failure #Hypernatremia
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... Hyponatremia: Hyperglycemia ... irrigants Hypotonic Hyponatremia ... failure, Cirrhosis, Nephrotic ... syndrome -
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... Pain/Post-op • Neurologic ... Cirrhosis • Nephrotic ... osmole intake #Hyponatremia
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Syndrome of Inappropriate ... Pain/Post-op • Neurologic ... Cirrhosis • Nephrotic ... osmole intake #Hyponatremia
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... liver failure, nephrotic ... syndrome ... thecurbsiders #Hyponatremia ... #causes #nephrology
Hypernatremia Management Algorithm
Acute vs Chronic
Calculate Losses
 • Current water Deficit
 • Ongoing Free water Losses
 •
Hypernatremia Management ... Algorithm Acute ... Medicine @SCVMCMed #Hypernatremia ... #Management #Algorithm ... #treatment #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... , UNa < 20 • Nephrotic ... Cardiac failure #Hyponatremia ... #Causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... CHF, cirrhosis, nephrotic ... syndrome) Euvolemic ... UnremarkableLab #Hyponatremia
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... failure, Cirrhosis, Nephrotic ... syndrome • Urine ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia - ... Extrarenal Hypernatremia ... Ingestion Renal Hypernatremia ... MatthewHoMD #Hypernatremia ... #nephrology #sodium