Pearls from Dr. Sumit Mohan

63 yo woman with schizophrenia presenting with confusion found to have hyponatremia to 113

2016-12-01

  • Psychotropic Meds and Hyponatremia

    Posted 12/01/16 10:36:29 AM by Anna Krigel

  • Low BUN - seen in vegetarians and those with a low protein diet; can be important in the evaluation of hyponatremia as low BUN can signal a low solute intake
    Hypokalemia - low potassium can be seen in hyponatremia secondary to Na/K exchange in the distal tubule

    Posted 12/01/16 10:37:10 AM by Anna Krigel

  • Use urine specific gravity on the UA to predict urine osmolality: Drop the 1 and decimal points and multiply by 3 

    Posted 12/01/16 10:46:54 AM by Anna Krigel

  • Adrogue-Madias Formula - most widely used formula to predict the rate of correction of the sodium level; however, in patients treated with hypertonic saline, the formula tends to underestimate the rate of correction

    Posted 12/01/16 11:27:03 AM by Anna Krigel

  • Factors that Increase Risk for Osmotic Demyelination Syndrome

    Posted 12/01/16 11:29:44 AM by Anna Krigel

  • For further reading...

    Hyponatremia (NEJM)
    The Adrogue-Madias Formula Revisited (CJASN)
    Hypertonic Saline for Hyponatremia: Risk of Inadvertent Overcorrection (CJASN)

    Posted 12/01/16 11:31:55 AM by Anna Krigel


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