Hypernatremia

Question 1

Hypernatremia is defined as serum [Na+]

Answer 1

> 150 mEq/L

Question 2

Important aetiologies of hypernatremia in ED (4)

Answer 2

1 Inadequate water intake
2 Mineralocorticoid or glucocorticoid excess*
3 GI* ;Vomiting, diarrhea, intestinal fistula
4 Osmotic diuresis

Question 3

DIABETES INSIPIDUS, Urine osmolality is …

Answer 3

low (200 to 300 mOsm/kg, with urinary [Na+] of 60 to 100 mEq/kg)

Question 4

DIABETES INSIPIDUS may be … or …

Answer 4

central or nephrogenic

Question 5

Central DI differential (5)

Answer 5

1 Neoplasm
2 Pituitary surgery
3 Trauma
4 Granulomas
5 Idiopathic

Question 6

Nephrogenic DI differential (7)

Answer 6

1 Familial
2 Hypercalcemia
3 Hypokalemia
4 Renal disease 
5 Drug Induced
6 Hematologic disorders
7 Malnutrition

Question 7

Hypernatremia symptoms (8)

Answer 7

Restlessness, irritability Tremulousness, ataxia

Hyperreflexia, twitching, spasticity,Seizures and death

Question 8

In hypernatremia If the plasma osmolality >, the incidence of severe morbidity or mortality may exceed

Answer 8

350 mOsm/kg

50%.

Question 9

Water deficit formula

Answer 9

Wt x 0.6 x ({ [Na]/140}-1)

Question 10

each liter of water deficit results in serum [Na+] rise of

Answer 10

3 to 5 mEq/L

Question 11

The reduction in [Na+] should not exceed mEq/L per day.

Answer 11

10 to 15

Question 12

In acute hypernatremia, serum [Na+] levels can be corrected rather

Answer 12

rapidly with little fear of cerebral edema