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 ... HYPOVOLEMIC β€’ extra-renal ... - fevers β€’ renal ... Workup #Algorithm #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... - Differential ... Pain/Post-op β€’ Neurologic ... GI losses β€’ Renal ... #Nephrology #Differential
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... High Uric Acid β†’ renal ... Rachel Stern MD #Hyponatremia ... #Differential # ... Diagnosis #Algorithm #nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 β€’ Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... β€’ Renal Failure ... Hypovolemic - GI losses, renal ... #Differential # ... Algorithm #causes #nephrology
Hyponatremia Diagnosis Algorithm
UOsm β‰₯ POsm - Vasopressin-Dependent
 β€’ UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... solute intake, Renal ... @NephroMD #hyponatremia ... #diagnosis #differential ... algorithm #causes #nephrology
Hyponatremia - Differential Diagnosis and Evaluation Algorithm
In addition to edema and urine concentration, always consider urine
Hyponatremia - Differential ... when evaluating hyponatremia ... amzn.to/3rEtbK8 #Hyponatremia ... #Differential # ... Evaluation #Algorithm #nephrology
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 β€’ Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... - Differential ... perspiration Renal ... #Differential # ... Diagnosis #Causes #nephrology
True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
True Hyponatremia ... Differential Algorithm ... and hypervolemic hyponatremia ... #Differential # ... Algorithm #Diagnosis #Nephrology
Hypernatremia Management Algorithm
Acute vs Chronic
Calculate Losses
 β€’ Current water Deficit
 β€’ Ongoing Free water Losses
 β€’
Hypernatremia Management ... Medicine @SCVMCMed #Hypernatremia ... #Management #Algorithm ... #treatment #nephrology
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
Algorithm and Differential ... blood count with differential ... inflammatory markers β€’ Cardio-renal ... CK-MB, NT-proBNP, cardiac ... #Diagnosis #nephrology