Disorders of Water Balance: Hyponatremia Mnemonics

Question 1

What does the mnemonic ‘SALT LOSS’ represent?

Answer 1

Causes of Hypernatremia:
* Saline excess (iatrogenic)
* Aldosteronism (primary)
* Lithium/loop diuretics
* Thirst impairment (hypodipsia)
* Lactulose/diarrhea
* Osmotic diuresis (mannitol, glucose)
* Skin losses (burns, sweating)
* Syndrome of DI (central/nephrogenic)

Each letter in ‘SALT LOSS’ corresponds to a different cause of hypernatremia.

Question 2

What symptoms are associated with hypernatremia according to the mnemonic ‘DRY BRAIN’?

Answer 2

Symptoms:
* Drowsiness
* Restlessness
* Yawning
* Brain hemorrhage (severe cases)
* Reflexes hyperactive
* Ataxia
* Irritability
* Nuchal rigidity → Seizures/Coma

‘DRY BRAIN’ helps remember the key symptoms of hypernatremia.

Question 3

What is the first step in the workup for Diabetes Insipidus as per the mnemonic ‘DI Dx’?

Answer 3

Dehydration test (water deprivation)

The ‘DI Dx’ mnemonic outlines the initial steps to diagnose Diabetes Insipidus.

Question 4

What does ‘3D Treatment’ refer to in the management of hypernatremia?

Answer 4

Management Steps:
* Deficit calculation (TBW × (Na⁺current/Na⁺desired - 1))
* Duration (acute vs. chronic correction rates)
* Dextrose/saline choice:
- Hypotensive? NS first
- Euvolemic? D5W/0.45% saline
- Hypervolemic? Lasix + free water

‘3D Treatment’ provides a structured approach to manage hypernatremia.

Question 5

Identify the ICU risk factors for hypernatremia as per ‘HIGH Na⁺’.

Answer 5

ICU Risk Factors:
* Hyperalimentation (TPN)
* Intubation (insensible losses)
* Glucose (hyperglycemic diuresis)
* Hypotonic fluid neglect
* Na⁺ overload (saline resuscitation)

‘HIGH Na⁺’ helps recall the risk factors associated with hypernatremia in ICU settings.

Question 6

What is the maximum rate of correction for chronic hypernatremia as per ‘Na⁺ CORRECT’?

Answer 6

Never >12 mEq/24h (chronic)

The ‘Na⁺ CORRECT’ mnemonic highlights safe correction rates for hypernatremia.

Question 7

What triggers nephrogenic Diabetes Insipidus according to ‘LITHIUM’?

Answer 7

Nephrogenic DI Triggers:
* Lithium toxicity
* Interstitial nephritis
* Tubulopathies (e.g., Fanconi)
* Hypercalcemia
* Infections (pyelonephritis)
* Uremia (CKD)
* Myeloma (light chains)

‘LITHIUM’ lists potential triggers for nephrogenic Diabetes Insipidus.

Question 8

Fill in the blank: The mnemonic ‘HIGH Na⁺’ includes risk factors such as Hyperalimentation, Intubation, Glucose, Hypotonic fluid neglect, and _______.

Answer 8

Na⁺ overload (saline resuscitation)

This fill-in-the-blank reinforces the key risk factors for hypernatremia.

Question 9

True or False: The ‘DRY BRAIN’ mnemonic includes symptoms such as seizures and coma.

Answer 9

True

The ‘DRY BRAIN’ mnemonic emphasizes severe symptoms associated with hypernatremia.