12 results
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
and Workup Step ... Repeat the sodium ... • psychogenic polydipsia ... #Diagnosis #Workup ... #Algorithm #Nephrology
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Workup Algorithm ... mechanism 2) Volume ... • Euvolemic (Low ... #Algorithm #nephrology ... #sodium
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
Volume Based Approach ... to Hyponatremia ... deficiency, Primary polydipsia ... algorithm #diagnosis #sodium ... #low #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... in addition) of volume ... low, uric acid ... #Differential # ... Algorithm #Diagnosis #Nephrology
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
can be high or low ... intake (Primary polydipsia ... ), Low solute intake ... #differential # ... #nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Hypovolemic - Give volume ... - Primary Polydipsia ... Algorithm #diagnosis #nephrology ... #sodium
Modified Hyponatremia Algorithm
Hypertonic Hyponatremia: Hyperglycemia, Mannitol, Urologic irrigants
Hypotonic Hyponatremia: 
 • ADH ON (UOsm > 100):
Modified Hyponatremia ... 100): Primary polydipsia ... , Low solute intake ... Algorithm #diagnosis #sodium ... #nephrology
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Consider: Primary polydipsia ... , Low solute intake ... #diagnosis #differential ... algorithm #causes #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Beer Potomania - Low ... • Psychogenic Polydipsia ... #Differential # ... Algorithm #causes #nephrology
Hyponatremia - Differential Algorithm
Isotonic Hyponatremia: Hyperlipidemia, Hyperproteinemia, Recent TURP
Hypotonic Hyponatremia: 
 • Hypovolemia: Diuretics/Nephropathies, Vomiting, Diarrhea,
Hyponatremia - Differential ... Potomania, Psychogenic polydipsia ... #Differential # ... diagnosis #causes #nephrology ... #sodium #low