11 results
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Algorithm Hypertonic ... OFF (UNa > 30): SIADH ... , Medications (diuretics ... #Algorithm #diagnosis ... #sodium #nephrology
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 ... , Renal Sodium loss ... differential #diagnosis ... #table #sodium
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... #Diagnosis #Workup
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Hypovolemia: Diuretics ... • Euvolemia: SIADH ... Alcohol MH/CCF ... #diagnosis #causes ... #nephrology #sodium
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis ... Workup Algorithm ... 1) Check Urine ... #Workup #Algorithm ... #nephrology #sodium
Causes of Hypernatremia - Differential Diagnosis Algorithm
Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L
High
- Differential Diagnosis ... Algorithm Hypernatremia ... water loss, Serum Sodium ... 300 mmol/kg • Hypertonic ... administration • Osmotic diuresis
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.
Hyponatremia - Diagnosis ... 3 questions to work ... 1) Is it hypotonic ... Measure urine osmolality ... #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
Hyponatremia Differential Diagnosis Algorithm in Cancer
UOsm ≥ 100 mOsm/kg = Urine is inappropriately concentrated for hypotonic
Diagnosis Algorithm ... 100 mOsm/kg = Urine ... concentrated for hypotonic ... inappropriate • SIAD ... #Cancer #algorithm