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| General Info |
HPI/Physical |
| Patients can present with altered mental status. This is very common in older patients and is ususally chronically low. The main concern is treating it before it gets low enought to cause seizures and not correcting too quickly to avoid Central Pontine Myelinolysis . | Symptoms: Abdominal pain, Headache, Agitation, Hallucinations, Cramps, Confusion. Lethargy, Seizures, Polydipsia, Polyuria, Diarrhea, Vomiting, Dyspnea, Swelling |
| Hypertonic (>300mOs/Kg) | Isotonic
(275-300mOs/Kg) |
Hypotonic
(<275mOs/Kg) |
| Hyperglycemia Increase sodium by 1.6 for every
100mg/dL
over 100
MannitolUremia |
Due to lab artifact, rare
HyperlipidemiaParaproteinemia Multiple Myeloma, MGUS, Leukemia
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See below |
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Volume Overload:
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Euvolemic: |
Volume Depleted (Dehydrated):
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| Water overload and
salt
overload, body thinks your empty when you
are not. Urine Na > 20, FeNa > 1% points to RF Urine Na < 10, FeNa < 1% points to others |
This is due to
excessive free
water intake or the inability to
excrete free water Uosm > 100 points to inability to excrete Uosm < 100 points to excess free water intake |
Your body thinks
that you are
empty and you are Urine Na < 10, FeNa < 1% non renal Urine Na > 20, FeNa > 1% renal |
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| Congestive
heart failure Cirrhosis Nephrotic Syndrome Renal Failure |
Excess
intake:
Psychiatric polydipsiaHypothalamic infarct Inability
to
excrete free water:
Addison's diseaseHypothyroid Reset Osmostat Potomania SIADH |
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