15 results
Hyponatremia Correction
1. Indications for Hypertonic Saline: seizure, coma, focal findings
   - typically occurs with
Hyponatremia Correction ... 100-110 - Symptoms ... Demyelination Syndrome ... 3cc/kg/h, loop diuretics ... desmopressin MH/CCF
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
• Euvolemic (Low ... • Hypovolemic: Diuretics ... , Cushing syndrome ... Workup #Algorithm #nephrology ... #sodium
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Repeat the sodium ... volume loss - diuretics ... HYPERVOLEMIC • CHF ... • nephrotic syndrome ... Workup #Algorithm #Nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Sodium loss (diuretics ... can be high or low ... Cirrhosis, Nephrotic syndrome ... Primary polydipsia), Low ... #nephrology
Hypokalemia - Differential Diagnosis Algorithm

Transcellular Shift:
 • Alkalosis
 • ↑ beta-2 adrenergic simulation 
 • Erythropoiesis
anemia) • G-CSF ... • Refeeding syndrome ... vomiting) • Low ... • Discontinued diuretic ... #low #potassium
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
Treatment: Treatment ... demyelination syndrome ... include vaptans (HF ... #management #nephrology ... #sodium
Management of Hyponatremia
Hypertonic Saline - Only indicated if patient has severe symptoms + Na < 125
Give
Management of Hyponatremia ... patient has severe symptoms ... Failure - Add Diuretics ... Add Diuretics, Consider ... #sodium
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
• Hypovolemia: Diuretics ... Cirrhosis, Nephrotic Syndrome ... , Chronic Renal ... Alcohol MH/CCF ... #sodium #low
Diuretics and Agents Regulating Renal Excretion

Carbonic Anhydrase Inhibitors (Acetazolamide, Dichlorphenamide)
 • Glaucoma
 • Epilepsy
 • Altitude
Hyponatremia ... Tolvaptan) • Treatment ... and euvolemic hyponatremia ... #Diuresis #Nephrology ... #Pharmacology #
Causes of Hypomagnesemia
 • Redistribution: IV glucose, Correction of diabetic ketoacidosis, IV hyperalimentation, Refeeding after starvation,
Redistribution: IV glucose, Correction ... Saline or osmotic diuresis ... , Potassium depletion ... • Drugs: Loop diuretics ... #magnesium #low