10 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... volume loss - diuretics ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... #Algorithm #Nephrology
Hyponatremia Treatment Algorithm

CHF, Cirrhosis - Fluid restriction
SIADH - Fluid restriction
 - Consider salt tablets if etiology
Hyponatremia Treatment ... Algorithm CHF ... Fluid restriction SIADH ... -> free water diuresis ... #Treatment #Algorithm
Flowchart to diuretic use in acute heart failure.

(A) Congestion with volume overload. 

(B) Treatment algorithm after
(B) Treatment algorithm ... intravenous; SGLT2‐I, sodium–glucose ... ultrafiltration; UO, urine ... #CHF #Algorithm ... #HeartFailure #Cardiology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... Algorithm 1) ... Check Urine Osmolality ... • Hypovolemic: Diuretics ... #sodium
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
normal volume-based algorithm ... Urine Na+K / serum ... restriction alone in SIADH ... Present (Uosm ≥100): SIADH ... , Renal Sodium loss
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Algorithm Isotonic ... • Hypovolemia: Diuretics ... • Euvolemia: SIADH ... Alcohol MH/CCF ... causes #nephrology #sodium
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... Normalizes in SIADH ... • IF SIADH — ... #Management #algorithm ... #treatment #sodium
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
3 questions to work ... Measure urine osmolality ... Treatment: Treatment ... include vaptans (HF ... management #nephrology #sodium
Primary Polydipsia
Definition: Excessive volitional water intake
Epidemiology:
 • 6-20% of patients with psychiatric disorders - Most commonly
hypothalamic thirst center ... Pseudohyponatremia, SIADH ... intoxication Initial Workup ... Osm, Serum Sodium ... , Urine Sodium
It is important to recognize Acute Decompensated Heart Failure (ADHF) as more than just simply a
status and low urine ... excreted using diuretics ... #differential #algorithm ... #management #cardiology ... #heartfailure #chf