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Hyponatraemia Flashcards

1
Q

What is acute hyponatraemia?

A

Develops over a period of less than 48 hours

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2
Q

What is chronic hyponatraemia?

A

Develops over a period of more than 48 hours

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3
Q

What is mild hyponatraemia?

A

130-134mmol/L

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4
Q

What is moderate hyponatraemia?

A

120-129mmol/L

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5
Q

What is severe hyponatraemia?

A

<120mmol/L

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6
Q

What are the early symptoms of hyponatraemia?

A

Headache
Lethargy
Nausea
Vomiting
Dizziness
Confusion
Muscle cramps

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7
Q

What are the late symptoms of hyponatraemia?

A

Seizures
Coma
Respiratory arrest

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8
Q

What is the management of chronic hypovolaemic hyponatraemia?

A

Normal saline (0.9% NaCl)

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9
Q

What is the management of acute hyponatraemia with severe symptoms?

A

Hypertonic saline (3% NaCl)

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10
Q

What is the management of euvolemic hyponatraemia?

A

Fluid restrict to 500-1000ml/day

Consider
- Demeclocycline
- Vaptans (vasopressin)

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11
Q

What is the management of hypervolemic hyponatraemia?

A

Fluid restrict to 500-1000ml/day
Consider loop diuretics
Consider vaptans

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12
Q

What are the causes of hypovolaemic hyponatraemia?

A

Diuretic stage of renal failure
Diuretics
Addisonian crisis

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13
Q

What are the causes of euvolemic hyponatraemia?

A

SIADH

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14
Q

What are the causes of hypervolemic hyponatraemia?

A

Heart failure
Liver failure
Nephrotic syndrome

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15
Q

What is osmotic demyelination syndrome?

A

A complication of hyponatraemia treatment. It happens due to over-correction of severe hyponatraemia

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16
Q

What is the pathophysiology of osmotic demyelination syndrome?

A

In chronic hyponatraemia there is the loss of active organic osmolytes from astrocytes. These provide protection against cerebral oedema.

Organic osmolytes cannot be replaced quickly enough when the brain volume begins to shrink in response to correction of hyponatraemia

17
Q

What are the symptoms of osmotic demyelination syndrome?

A

Dysarthria
Dysphagia
Paraparesis
Seizures
Confusion
Coma

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