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clinical diagnosis pocus ultrasound management differential radiology algorithm nephrology msk fluid comparison effusion abdominal causes pulmonary treatment table pathophysiology video
Urine chemistry tests for the diagnostic evaluation of a patient with polyuria UOsm <100 mOsm/Kg (H2O diuresis)
with polyuria UOsm ... nephrogenic) UOsm ... diuresis (intravenous fluids ... × (Na + K) << UOsm ... diagnosis #nephrology #Uosm
Hyponatremia Treatment Algorithm CHF, Cirrhosis - Fluid restriction SIADH - Fluid restriction - Consider salt tablets if etiology
CHF, Cirrhosis - Fluid ... restriction SIADH - Fluid ... reversible - If Uosm ... depletion - IV Fluids ... polydipsia - Normalize fluid
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Diagnosis Algorithm UOsm ... ≥ POsm - Vasopressin-Dependent ... Cortisol deficiency UOsm ... < POsm - Vasopressin-independent
Polyuria - Differential Diagnosis Algorithm Urine Output > 3L /day Water Diuresis (Urine Osm <100 mOsm/kg) • Primary
Diuresis (Urine Osm ... <100 mOsm/kg) ... Diuresis (Urine Osm ... 100-200 mOsm/kg ... 300-500 mOsm/kg
Hypo-osmolar Hypotonic HypoNatremia Algorithm (Serum Na+ < 135 meq/L, serum Osm < 275 mosm/kg) Assess Volume Status,
135 meq/L, serum Osm ... < 275 mosm/kg) ... Urine Na, Urine Osm
Fluids, Electrolytes, Acid-Base ) General Concepts > < Osmolality vs osmolarity ★ Osmolality [H 20) Milliosmoles per kg of water. The osmolality is the
Fluids, Electrolytes ... the number of (mOsm ... of Na +1 Osm of ... Osmolarity (mOsm ... #Fluids #Electrolytes
IV Fluids - Comparison Table Fluid - pH - Osm - Na - Cl - Other •
IV Fluids - Comparison ... Table Fluid - ... pH - Osm - Na - ... EmmGeezee #IV #Fluids
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
Consider whether Posm ... Step 2: Check Uosm
Central vs Nephrogenic Diabetes Insipidus - Desmopressin Challenge Give desmopressin (intranasal, SQ, IV) and monitor UOsm every
IV) and monitor UOsm ... • No Rise in UOsm ... < 45% rise in UOsm ... 15-50% rise in UOsm ... CDI • Rise in UOsm
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
• ADH Present (Uosm ... be high or low Uosm ... ADH Not Present (Uosm ... • ADH Present (Uosm ... ADH Not Present (Uosm
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