jake @Jmarasco on GrepMed

Visual Field Pathways and Deficits 1 Total blindness of right eye due to complete lesion of right optic nerve 2 Bipolar hemianopia due to midline chiasmal lesion 3 Right nasal hemianopia to lesion involvlng right perichiasmal area 4 Left homonymous hemianopia due to or pressure on right optic tract 5 Left homonymous inferior quadrantanopia due to involvement Of lower right optic radiations 6 Left homonyrnous superior quadrantanopia duo to involvement of upper right Optic radiations 7 Left homonymous hemianopia due to lesion of right occipital lobe #VisualField #Pathways #Deficits #Hemianopsia #Hemianopia #Diagnosis #lesions #differential #ophthalmology

Diagnosis and Management of Hypernatremia #Hypernatremia #Differential #Algorithm #Causes #Nephrology #Diagnosis ** GrepMed Recommended Text: Nephrology Secrets - https://amzn.to/2Z74DhY

Hypernatremia Diagnosis and Workup Step 1 . Repeat the sodium concentration. Step 2. Check plasma osmolality. NORMAL PLASMA OSMOLALITY 285-295 mmol/L - pseudohyponatremia • hyperlipidemia • hyperproteinemia DECREASED PLASMA OSMOLALITY < 285 mmol/L - true hyponatremia INCREASED PLASMA OSMOLALITY > 295 mmol/L - pseudohyponatremia • hyperglycemia • mannitol administration Step 3. Assess volume status. HYPOVOLEMIC • extra-renal volume loss - diarrhea - vomiting - burns - fevers • renal volume loss - diuretics EUVOLEMIC • SIADH • hypothyroidism • adrenal insufficiency • psychogenic polydipsia HYPERVOLEMIC • CHF • liver failure • nephrotic syndrome • renal failure #Hypernatremia #Diagnosis #Workup #Algorithm #Nephrology

Causes of Hypernatremia - Differential Diagnosis Algorithm Hypernatremia - Excess free water loss, Serum Sodium >145 mmol/L High Urine Osmolality > 300 mmol/kg • Hypertonic saline administration • Osmotic diuresis (see Polyuria scheme) e.g., mannitol, glucosuria Low Urine Osmolality < 300 mmol/kg • Diabetes Insipidus Hypodipsia - Decreased intake of water • Decreased level of consciousness • No access to water GI loss • Watery Diarrhea Insensible loss • Burns • ICU patients • Fever • Inadequate intake for exercise-related loss • Hyperventilation #Hypernatremia #Nephrology #Differential #Diagnosis #Algorithm #Causes

Diagnosis and Management of Hyponatremia #Hyponatremia #Algorithm #Differential #Diagnosis #Management #Nephrology ** GrepMed Recommended Text: Nephrology Secrets - https://amzn.to/2Z74DhY

Hyponatremia Differential Diagnosis Algorithm #Hyponatremia #Differential #Diagnosis #Algorithm

Hyponatremia - Differential Diagnosis by Mechanism Decr Blood Pressure (“Decr Effective Circulating Volume”) - Volume depletion - Heart failure - Cirrhosis Syndrome of Inappropriate ADH secretion (SIADH) - Malignancy (e.g. small cell carcinoma of the lung) - CNS pathology (e.g. strokes, hemorrhage) - Pulmonary pathology (e.g. pneumonia, COPD exacerbation) - Drugs (e.g. carbamazepine, cyclosporine, SSRIs) Severe pain - Reset osmostat - Cerebral salt wasting Endocrinopathies - Hypothyroidism - Adrenal insufficiency ADH Appropriately Suppressed - Advanced renal failure - Primary polydipsia - Beer potomania - “Tea and toast” diet Dr. Eric Strong https://twitter.com/DrEricStrong #Hyponatremia #Differential #Diagnosis #Table #Causes #Sodium

Causes of Hypernatremia - Differential Diagnosis Inadequate water intake: • Lack of access to water Extrarenal hypotonic fluid loss: • GI losses or perspiration Renal concentrating defect: • Diuretics • Osmotic diuresis • Central diabetes insipidus • Nephrogenic diabetes insipidus Excessive salt intake: • Hypertonic fluid administration #Hypernatremia #Differential #Diagnosis #Causes #nephrology #sodium #high

Differential Diagnosis and Evaluation of Hypernatremia #Diagnosis #EM #IM #Nephro #Hypernatremia #Algorithm #VolumeStatus #Differential #DiabetesInsipidus #Ddxof

Diabetes Insipidus vs Syndrome of Inappropriate ADH (SIADH) - Comparison Table Diabetes Insipidus - Inadequate ADH SIADH - Excess ADH #Diabetes #Insipidus #SIADH #Comparison #Table #Pathophysiology #Signs #Symptoms #Diagnosis #Endocrinology