Disorders of Water Balance: Hyponatremia Mnemonics

Question 1

What does the mnemonic ‘SLOSHED’ represent?

Answer 1

Causes of Hypovolemic Hyponatremia:
* Sweating (excessive)
* Laxatives / Losses (GI: vomiting, diarrhea)
* Over-diuresis (diuretics)
* Salt-wasting nephropathy
* Hemorrhage
* Endocrine (Addison’s, hypoaldosteronism)
* Dehydration

Mnemonic to remember causes of hypovolemic hyponatremia

Question 2

What does the mnemonic ‘CHASER’ represent?

Answer 2

Causes of Hypervolemic Hyponatremia:
* Cirrhosis
* Heart failure
* Acute/chronic kidney disease
* Severe nephrotic syndrome
* Edematous states
* Renal failure

Mnemonic to remember causes of hypervolemic hyponatremia

Question 3

What does the mnemonic ‘SADHOG’ represent?

Answer 3

Causes of Euvolemic Hyponatremia:
* SIADH (Syndrome of Inappropriate ADH)
* Adrenal insufficiency
* Drugs (SSRIs, diuretics, carbamazepine)
* Hypothyroidism
* Osmotic reset (reset osmostat)
* Glucocorticoid deficiency

Mnemonic to remember causes of euvolemic hyponatremia

Question 4

What does the mnemonic ‘FATS’ represent?

Answer 4

Causes of Pseudohyponatremia:
* False (lab artifact, indirect ion-selective electrode)
* Abnormal proteins (multiple myeloma)
* Triglycerides (severe hypertriglyceridemia)
* Solids displacing water (lipoprotein X in jaundice)

Mnemonic to remember causes of pseudohyponatremia

Question 5

What are the diagnostic criteria for SIADH as represented by the mnemonic ‘SALT LOSS’?

Answer 5

SIADH Diagnostic Criteria:
* Sodium low (<135 mEq/L)
* Aldosterone low (urine Na⁺ >20 mEq/L)
* Low BUN/Cr (dilutional)
* Thyroid/adrenal normal (must exclude)
* Low serum uric acid
* Osmolality low (<275 mOsm/kg)
* Saline infusion doesn’t correct Na⁺
* Symptoms (if severe: confusion, seizures)

Mnemonic to remember SIADH diagnostic criteria

Question 6

What does the mnemonic ‘GLUCOSE’ represent?

Answer 6

Causes of Hypertonic Hyponatremia (Translocational):
* Glucose (severe hyperglycemia)
* Low Na⁺ (correct with 1.6 mEq/L per 100 mg/dL glucose)
* Urea (high osmolality but doesn’t cause hyponatremia)
* Contrast agents
* Osmolal gap elevated (>15 mOsm)
* Sucrose/maltose (IV solutions)
* Ethanol/methanol (osmolal gap but no hyponatremia)

Mnemonic to remember causes of hypertonic hyponatremia

Question 7

What does the mnemonic ‘PEE’ indicate regarding urine osmolality?

Answer 7

Urine Osmolality Clues:
* Polydipsia (psychogenic): Urine Osm <100 mOsm
* Euvolemia (SIADH): Urine Osm >100 mOsm
* Edema (CHF/cirrhosis): Urine Osm >100 mOsm

Mnemonic to remember urine osmolality clues

Question 8

What does the mnemonic ‘SLOW D’ indicate for treatment speed?

Answer 8

Treatment Pearls for Correction Speed:
* Slow correction (≤6–8 mEq/L in 24h)
* Limit rise (avoid osmotic demyelination)
* Overcorrection → DDAVP
* Water restriction (SIADH)
* Diuretics (hypervolemic cases)

Mnemonic to remember treatment pearls for hyponatremia

Question 9

What does the mnemonic ‘NAUSEA’ represent in relation to hyponatremia symptoms?

Answer 9

Hyponatremia Symptoms:
* Nausea/vomiting
* Ataxia (gait imbalance)
* Unconsciousness (severe cases)
* Seizures
* Encephalopathy
* Anorexia

Mnemonic to remember symptoms of hyponatremia