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Classification, Differential Diagnosis, and Features of Hyponatremia According to Volume Status 

Hypervolemic hypernatremia 
 - CHF
Volume Status Hypervolemic ... SIADH Renal hypovolemic ... nephropathy Extrarenal hypovolemic
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Hypernatremia: • Hypovolemic ... access to H2O • Hypervolemic ... Hypernatremia: • Hypovolemic ... nephrogenic) • Hypervolemic
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
uric acid high in hypovolemic ... and hypervolemic
Differential Diagnosis and Evaluation of Hyponatremia:
1) Identification of onset (acute vs. chronic)
2) Presence of symptoms (HA,
#Hyponatremia #Hypovolemic ... #Euvolemic #Hypervolemic
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Dependent: • Hypovolemic ... • Hypervolemic
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
HYPOVOLEMIC • ... psychogenic polydipsia HYPERVOLEMIC
Volume Based Approach to Hyponatremia
Hypovolemic, Serum uric acid >4
 • Urine Na <20: Extra-renal losses
 •
to Hyponatremia Hypovolemic ... Primary polydipsia Hypervolemic
Hypernatremia Classification and Features According to Volume Status
 - Hypervolemic hypernatremia - Cushing's syndrome, Primary hyperaldosteronism,
Volume Status - Hypervolemic ... Hypodipsia - Renal hypovolemic ... - Extrarenal hypovolemic
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Diagnosis Algorithm Hypovolemic ... - Give volume Hypervolemic
Summary Table of how the 4 types of shock affect the circulatory system: 
 - Hypovolemic
circulatory system: - Hypovolemic ... Comparison #Table #Hypovolemic