Dr. Gerald Diaz @GeraldMD
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Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - 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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Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... mmol/L - true hyponatremia ... failure #Hypernatremia ... #Diagnosis #Workup ... #Algorithm #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... Algorithm Syndrome ... Malignancy True hypovolemia ... osmole intake #Hyponatremia ... #Algorithm #Causes
Hyponatremia Diagnosis Algorithm
UOsm β‰₯ POsm - Vasopressin-Dependent
 β€’ UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... EABV) - Consider: Hypovolemia ... solute intake, Renal ... @NephroMD #hyponatremia ... #algorithm #causes
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 β€’ Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Diagnosis Algorithm ... Hypothyroidism, adrenal ... thecurbsiders #Hyponatremia ... #Algorithm #causes
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (β€œDecr Effective Circulating Volume”) 
 - Volume depletion
Hyponatremia - Differential ... Decr Blood Pressure ... Hypothyroidism - Adrenal ... DrEricStrong #Hyponatremia ... #Table #Causes
Adrenal Insufficiency Differential Diagnosis Algorithm
Clinical suspicion: Weakness, fatigue, nausea, musculoskeletal pain, dizziness, volume depletion, abdominal pain,
Differential Diagnosis ... Algorithm Clinical ... Weakness, fatigue, nausea ... , hypotension, hyponatremia ... , hyperkalemia,
Etiologies of Hypernatremia - Differential Diagnosis
GI losses / Insensible losses
Sodium Overload
Transcellular Movement of Water
Central Diabetes Insipidus
Etiologies of Hypernatremia ... - Differential Diagnosis ... hypercalcemia - Chronic hypokalemia ... DrEricStrong #Hypernatremia ... #Table #Causes
Hyponatremia - Diagnostic Evaluation Algorithm

Step 1: Consider whether Posm may actually be normal or elevated
Step 2:
Hyponatremia - Diagnostic ... Evaluation Algorithm ... considered likely, the cause ... DrEricStrong #Hyponatremia ... #Diagnosis #Workup
Physiologic Approach to Hypotonic Hyponatremia
The next time you have a case of hypotonic hyponatremia, give the
Approach to Hypotonic Hyponatremia ... of hypotonic hyponatremia ... normal volume-based algorithm ... Physiologic #Hypotonic #Hyponatremia ... #table #sodium
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... Diagnosis Algorithm ... treat underlying cause ... UnremarkableLab #Hyponatremia ... #Algorithm #diagnosis