7 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... EUVOLEMIC • SIADH ... HYPERVOLEMIC • CHF ... #Algorithm #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 ... 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 ... , Recent TURP Hypotonic ... • Euvolemia: SIADH ... Alcohol MH/CCF ... causes #nephrology #sodium
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
3 questions to work ... 1) Is it hypotonic ... Measure urine osmolality ... include vaptans (HF ... management #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
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 ... in Cancer UOsm ... 100 mOsm/kg = Urine ... concentrated for hypotonic ... inappropriate • SIAD