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diagnosis nephrology differential management table treatment evaluation hypotonic lazy low oncology physiologic polydipsia volume
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
Based Approach to Hyponatremia ... uric acid <4 • SIADH ... Glucocorticoid deficiency, Primary ... #algorithm #diagnosis ... #sodium #low #nephrology
Hyponatremia - Differential Diagnosis Algorithm Hypovolemic - Give volume Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm ... Solute Intake - Primary ... Pulmonary Diseases ... , SSRIs) - SIADH ... diagnosis #nephrology #sodium
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
Evaluation Algorithm ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... considered likely, the cause ... #Diagnosis #Workup
Physiologic Approach to Hypotonic Hyponatremia The next time you have a case of hypotonic hyponatremia, give the
time you have a case ... normal volume-based algorithm ... Urine Na+K / serum ... , Renal Sodium loss ... water intake (Primary
Hyponatremia - Differential Diagnosis by Mechanism Decr Blood Pressure (“Decr Effective Circulating Volume”) - Volume depletion
ADH secretion (SIADH ... hemorrhage) - Pulmonary ... renal failure - Primary ... Diagnosis #Table #Causes ... #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
Causes of Hyponatremia - Differential Diagnosis Algorithm Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... • Drugs • Pulmonary ... Hypo-osmolar urine ... suppression • Primary ... #Causes
Causes of Hyponatremia - Differential Diagnosis Algorithm Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... • Drugs • Pulmonary ... Hypo-osmolar urine ... suppression • Primary ... #Causes
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... include pain, primary ... promoting passive sodium ... Saline: • If Urine ... #Management #hyponatremia
A lazy man's classification of hyponatremia There are two possible approaches to the diagnosis of hyponatremia: .
serum osmolality, urine ... osmolality and urinary ... sodium). ... the patient has SIADH ... #Algorithm #Differential
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