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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True Hyponatremia Differential Algorithm

Instead (or in addition) of volume status examination, check urine sodium and serum
Differential Algorithm ... acid: - Urine sodium ... - Urine sodium ... #Differential # ... Algorithm #Diagnosis #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
Hypovolemic - Give volume
Hypervolemic (Edematous) - Look for and treat underlying cause
Hyponatremia - Differential ... treat underlying cause ... cirrhosis, nephrotic syndrome ... #Differential # ... #sodium
Causes of Hypernatremia - Differential Diagnosis
Inadequate water intake:
 • Lack of access to water
Extrarenal hypotonic fluid
Causes of Hypernatremia ... - Differential ... #Differential # ... Diagnosis #Causes ... #nephrology #sodium
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Causes of Hyponatremia ... - Differential ... Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... #Nephrology #Differential
Hyponatremia Differential Diagnosis Algorithm - Utilizing Uric Acid 
ADH promotes Urea/uric acid excretion along with water
Hyponatremia Differential ... Osmolarity 3) Urine Sodium ... #Differential # ... Diagnosis #Algorithm #nephrology ... #sodium #low #uricacid
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Hypernatremia Diagnosis ... Repeat the sodium ... mmol/L - true hyponatremia ... • nephrotic syndrome ... Workup #Algorithm #Nephrology
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Hyponatremia - Differential ... Tea and Toast Syndrome ... #Differential # ... Diagnosis #Algorithm #causes ... #nephrology
Hyponatremia - Diagnosis and Treatment
Hyponatremia is usually caused by the inability to excrete water normally.
is usually caused ... the underlying cause ... demyelination syndrome ... #Differential # ... #sodium
Hyponatremia - Differential Diagnosis by Mechanism
Decr Blood Pressure (“Decr Effective Circulating Volume”) 
 - Volume depletion
Hyponatremia - Differential ... - Cirrhosis Syndrome ... #Differential # ... Diagnosis #Table #Causes ... #Sodium
Hypernatremia Differential Diagnosis Algorithm - Diabetes Insipidus Workup

Step #1 - Consider the history
Step #2 - Assess
Hypernatremia Differential ... DrEricStrong #Hypernatremia ... Management #Algorithm #Sodium ... #nephrology #insipidus