Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief 🇵🇭 🇺🇸 - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Differential Diagnosis Algorithm ... polydipsia • Insufficient ... osmole intake #Hyponatremia ... #Causes
Hyponatremia Diagnosis Algorithm
UOsm ≥ POsm - Vasopressin-Dependent
 • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... intake, Renal insufficiency ... #differential #algorithm ... #causes #nephrology
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Adrenal Insufficiency ... Differential Diagnosis Algorithm ... Weakness, fatigue, nausea ... , hypotension, hyponatremia ... Differential #Diagnosis #Algorithm
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Hypothyroidism, adrenal insufficiency ... thecurbsiders #Hyponatremia ... #causes #nephrology
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... hypothyroidism • adrenal insufficiency ... renal failure #Hypernatremia ... Diagnosis #Workup #Algorithm
Adrenal Insufficiency Diagnosis Algorithm
Clinical features: 
 - Weight loss, anorexia, Weakness, fatigue, GI distress
 - Hypotension,
Adrenal Insufficiency ... Diagnosis Algorithm ... hypoglycemia, Hyponatremia ... findings (see algorithm ... #Diagnosis #Algorithm
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... treat underlying cause ... , CNS Disease, Meds ... UnremarkableLab #Hyponatremia
CLINICAL MANIFESTATIONS 
OF ADRENAL INSUFFICIENCY. 

Primary and secondary adrenal insufficiency:
 - Tiredness, weakness, mental depression
MANIFESTATIONS OF ADRENAL INSUFFICIENCY ... secondary adrenal insufficiency ... hypotension - Nausea ... , diarrhea - Hyponatremia ... Primary adrenal insufficiency
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
Hyponatremia - Differential ... Hypothyroidism - Adrenal insufficiency ... DrEricStrong #Hyponatremia ... Diagnosis #Table #Causes
Causes of Adrenal Insufficiency - Differential Diagnosis Algorithm
Autoimmune:
 • Isolated
 • Polyglandular autoimmune syndrome 1
 •
Causes of Adrenal ... Insufficiency - ... Differential Diagnosis Algorithm ... 2LmUODZ #Adrenal #Insufficiency ... #Causes