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Endocrinology Medicine > Hyponatraemia > Flashcards

Hyponatraemia Flashcards

1
Q

What is hyponatraemia?

A

Low serum sodium

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2
Q

What is normal sodium levels?

A

135-145

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3
Q

What are the symptoms of hyponatraemia?

A 
Headache
Nausea + Vomiting 
Cramps
Lethargy 
Seizures 
Coma
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4
Q

What else do you need to calculate?

A

Tonicity + volaemic status

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5
Q

How do you calculate serum tonicity?

A

2Na + glucose

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6
Q

What is the normal tonicity of hyponatraemia?

A

Hypotonic

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7
Q

What can cause low sodium?

A

Increase vasopressin
D+V
Increased fluid intake

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8
Q

What can cause hypertonic hyponatraemia?

A

Hyperglycaemia

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9
Q

How does hypertonicity cause hyponatraemia?

A

Water drawn from intracellular space into vascular space - dilutional effect

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10
Q

What can cause hypovolaemic hyponatraemia?

A

Kidneys

  • diuretics
  • adrenocortical insufficiency

D+V
Sweating
Pancreatitis
Burns

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11
Q

What can cause of euvolaemic hyponatreamia?

A

SiADH

Drugs

  • SSRIs
  • carbamezapine
  • TCAs

Pneumonia
TB
SCLC

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12
Q

What can cause hypervolaemic hyponatraemia?

A

Congestive heart failure
Liver cirrhosis
Renal failure

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13
Q

What are the investigations for suspected hyponatraemia?

A

Bloods

  • U+Es
  • FBC
  • LFTs
  • TFTs

Calculate osmolality
ECG
CXR
CT head

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14
Q

How do you calculate osmolality?

A

2(Na+K) + glucose + urea

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15
Q

How do you manage hyponatraemia acutely?

A

3% saline

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16
Q

How do you manage chronic hyponatreamia?

A

Replace with 0.9% saline until euvolaemic

17
Q

What is SiADH?

A

Syndrome of inappropriate ADH secretion

18
Q

How is SiADH diagnosed?

A

Urine

  • Na >20mmol/L
  • osmolality >500mosmol/kg

Hyponatraemia or low plasma osmolality

19
Q

What can cause SiADH?

A

Malignancy

  • SCLC
  • pancreas
  • prostate

Neurological - damage to hypothalamus/pituitary

  • stroke
  • Subdural
  • Subarachnoid
20
Q

How is SiADH managed?

A

Treat underlying cause

Fluid restrict

Endocrinology Medicine (22 decks)

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