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LECT_1

ECF and plasma tonicity

QuestionAnswer
Low Plasma [Na] and low plasma Osm Check urine osmolarity
Cause of pseudohyponatremia? high triglycerides, high protein
low urine osmolality (<100) with hyponatremia psychogenic polydipsia
high urine osmolality (>100) with hyponatremia def. in renal dilution (ABNL high ADH)
Causes of euvolemic hyponatremia? SIADH! GC def., hypothyroidism, drugs, tumor
low ECF with hyponatremia VOL. DEPL: Diarrhea, diuretics, MC def.
NL ECF with hyponatremia edematous disorders
hypertonic challenge with hypoVOL water loss - diarrhea/vomiting; skin loss; kidney (osm. diur.)
euvolemic hypertonicity pure water loss - DI (central/nephrogenic)
hypervolemic hypertonicity iatrogenic (hypertonic solutions); salty foods
correcting hyponatremia concentration raised at the rate that it falls; Rapid correction - no more than 12 mEq/L/24hr
hyponatremia correction EQUATION Na/hr = <delta>[Na]/hr x TBW
hypernatremia correction SLOWLY: half-correction in 24hr period TBW(present)*[Na](present) = TBW(nl) * [Na](nl)
Created by: MATTADOR
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