18 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... • nephrotic syndrome ... • renal failure ... #Diagnosis #Workup ... #Algorithm #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Tea and Toast Syndrome ... • Renal Failure ... #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Hypovolemia, UNa > 20: 
 • Renal losses, Diuretic excess,
Causes of Hyponatremia ... - Differential Diagnosis ... Algorithm Hypovolemia ... #Hyponatremia ... #nephrology
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... Cirrhosis, Nephrotic syndrome ... failure Satya ... #algorithm #diagnosis ... #sodium #low #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Algorithm Syndrome ... GI losses • Renal ... Congestive heart failure ... #Nephrology #Differential ... #Diagnosis #Algorithm
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Algorithm Syndrome ... GI losses • Renal ... Congestive heart failure ... #Nephrology #Differential ... #Diagnosis #Algorithm
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Hypovolemia, Heart failure ... solute intake, Renal ... #nephrology
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... Hypovolemia, Heart failure ... Cirrhosis, Nephrotic syndrome ... #Algorithm #diagnosis ... #sodium #nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... Workup Algorithm ... mOsm/kg - Implies renal ... , Cushing syndrome ... #nephrology #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... perfusion (Heart failure ... Cirrhosis, Nephrotic syndrome ... #differential #diagnosis ... table #sodium #nephrology