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diagnosis algorithm management differential nephrology hematology checklist evaluation causes treatment clinical anesthesia anesthesiology pulmonary endocrinology intraoperative criticalcare peds cardiology testing
Hypernatremia - Diagnostic Evaluation Algorithm Step 1: Consider history. Most patients presenting with hypernatremia are either very
Step 2: Check Uosm ... using initial Uosm ... Hypernatremia #Diagnosis #Workup
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 #Diagnosis #Workup
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup Step #1 - Consider the history Step #2 - Assess
Diabetes Insipidus Workup ... #2 - Assess the Uosm
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
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
Hypernatremia - Differential Diagnosis Workup Algorithm 1) Check Urine Osmolality: > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Osmolality: > 600 mOsm ... mechanism ≤ 600 mOsm ... Differential #Diagnosis #Workup
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
Urine chemistry tests for the diagnostic evaluation of a patient with polyuria UOsm <100 mOsm/Kg (H2O diuresis)
with polyuria UOsm ... nephrogenic) UOsm ... 2 × (Na + K) = UOsm ... × (Na + K) << UOsm ... diagnosis #nephrology #Uosm
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