10 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... HYPERVOLEMIC • CHF ... renal failure #Hypernatremia
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Diagnosis Algorithm ... Sodium 4) Serum ... Low Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Hyponatremia - Diagnostic ... Evaluation Algorithm ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... DrEricStrong #Hyponatremia
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... SatyaPatelMD #Volume #Hyponatremia ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... underlying cause (CHF ... , SSRIs) - SIADH ... UnremarkableLab #Hyponatremia ... diagnosis #nephrology #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... case of hypotonic hyponatremia ... normal volume-based algorithm ... Urine Na+K / serum ... Physiologic #Hypotonic #Hyponatremia
A lazy man's classification of hyponatremia
There are two possible approaches to the diagnosis of hyponatremia: .
classification of hyponatremia ... the diagnosis of hyponatremia ... serum osmolality, urine ... the patient has SIADH ... #Diagnosis #Hyponatremia
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... Hyponatremia: Hyperlipidemia ... TURP Hypotonic Hyponatremia ... • Euvolemia: SIADH ... causes #nephrology #sodium
Primary Polydipsia
Definition: Excessive volitional water intake
Epidemiology:
 • 6-20% of patients with psychiatric disorders - Most commonly
• Symptomatic hyponatremia ... with symptomatic hyponatremia ... Pseudohyponatremia, SIADH ... Osm, Serum Sodium ... , Urine Sodium
Hyponatremia Differential Diagnosis Algorithm in Cancer
UOsm ≥ 100 mOsm/kg = Urine is inappropriately concentrated for hypotonic
Hyponatremia Differential ... in Cancer UOsm ... 100 mOsm/kg = Urine ... inappropriate • SIAD ... metastases) #Hyponatremia