11 results
hyponatremia diagnosis differential management treatment cancer causes cerebral comparison hypernatremia hypotonic low oncology pathophysiology physiologic saltwasting table workup
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
than the normal volume-based ... algorithm Urine ... poor response to volume ... , Renal Sodium loss ... #nephrology
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Volume Based Approach ... uric acid <4 • SIADH ... #Hyponatremia #algorithm ... #diagnosis #sodium ... #low #nephrology
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Salt Wasting vs SIADH ... Neurological event 2) Sodium ... reabsorption 5) ↓ Na ... → Subclinical volume ... Pathophysiology #diagnosis #nephrology
Modified Hyponatremia Algorithm Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants Hypotonic Hyponatremia: • ADH ON (UOsm > 100):
- RAAS ON (UNa ... > 30): SIADH, Medications ... polydipsia, Low solute ... #diagnosis #sodium ... #nephrology
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis Algorithm ... Cirrhosis • UNa ... Inappropriate - Consider: SIADH ... polydipsia, Low solute ... #causes #nephrology
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... pain, primary lung ... administered • Can cause volume ... promoting passive sodium ... #hyponatremia #nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Differential Diagnosis Algorithm ... Hypovolemic - Give volume ... , SSRIs) - SIADH ... #diagnosis #nephrology ... #sodium
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... Pain, Primary lung ... This can cause volume ... promoting passive sodium ... #hyponatremia #nephrology
Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA
Repeat the sodium ... Assess volume status ... EUVOLEMIC • SIADH ... Diagnosis #Workup #Algorithm ... #Nephrology
Management of Hyponatremia Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125 Give
/L Raised ECF volume ... Normalizes in SIADH ... • IF SIADH — ... Hyponatremia #Management #algorithm ... #treatment #sodium
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