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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
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 ... differential #diagnosis #table
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
Consider whether Posm ... Step 2: Check Uosm
Hyponatremia Differential Diagnosis Table • Step 1: Correct for hyperglycemia. Corrected Na = [(glucose - 100)/
Differential Diagnosis Table ... BMP • Serum Osm ... • Urine Osm ... Differential #Diagnosis #Table
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
Hyponatremia Treatment Algorithm CHF, Cirrhosis - Fluid restriction SIADH - Fluid restriction - Consider salt tablets if etiology
Hyponatremia Treatment ... reversible - If Uosm ... Reset Osmostat - Treatment ... #Hyponatremia #Treatment
Summary table of the mechanism of action, side effect and contraindications of commonly used non-steroidal anti-inflammatory
Summary table of ... medical diagrams, tables ... #pharmacology #table ... #medications #treatment
Hypernatremia - Diagnostic Evaluation Algorithm Step 1: Consider history. Most patients presenting with hypernatremia are either very
Step 2: Check Uosm ... using initial Uosm
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