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diagnosis nephrology algorithm differential management sodium treatment cancer low oncology adh cerebral comparison cushings diabetes dm2 ebv emergencies evaluation hypercortisolism
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Osmolarity 2) Urine ... Osmolarity 3) Urine ... Low Uric Acid → SIADH ... Rachel Stern MD #Hyponatremia
Volume Based Approach to Hyponatremia Hypovolemic, Serum uric acid >4 • Urine Na <20: Extra-renal losses •
uric acid >4 • Urine ... Extra-renal losses • Urine ... uric acid <4 • SIADH ... uric acid >4 • Urine ... Nephrotic syndrome • Urine
Cerebral Salt Wasting vs SIADH - Pathophysiology 1) Neurological event 2) Sodium loss from tubules 3) Naturiesis →
Salt Wasting vs SIADH ... → Increased urine ... #SaltWasting #SIADH ... diagnosis #nephrology #hyponatremia
Hyponatremia - Diagnostic Evaluation Algorithm Step 1: Consider whether Posm may actually be normal or elevated Step 2:
Hyponatremia - Diagnostic ... Check Uosm and/or Urine ... tests Step 5: If SIADH ... DrEricStrong #Hyponatremia
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 ... volume-based algorithm Urine ... restriction alone in SIADH ... Present (Uosm ≥100): SIADH
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
Management of SIADH Treat underlying cause: • Causes can include pain, primary lung pathology, post-operative phenomenon, medications,
Management of SIADH ... colon 0.9% Normal Saline ... : • If Urine osmolality ... SatyaPatelMD #SIADH ... #Management #hyponatremia
Management of Hyponatremia Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125 Give
Management of Hyponatremia ... • Discuss with endocrinology ... — discuss with endocrinology ... Normalizes in SIADH ... • IF SIADH —
SIADH Treatment Options 1. Treat underlying cause of SIADH: Pain, Primary lung pathology, Post-operative phenomenon, Medications, Basically
SIADH Treatment ... underlying cause of SIADH ... 0.9% NS • If Urine ... Hypotension, Increased urine ... #Management #hyponatremia
Hyponatremia (<135 mEq/L) is a common electrolyte abnormality caused by an excess of total body water
serum osmolality, urine ... concentration and urine ... increase in the urine ... Measured urine sodium ... EBV #potomania #SIADH
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