hyponatraemia Flashcards

1
Q

broad subtypes of hyponatraemia

A

hypovolaemic, euvolaemic, hypervolaemic hyponatraemia

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2
Q

ddx for hypovolaemic hyponatraemia (6)

A

epithelial surface fluid loss

  • diarrhoeal illness
  • burns
  • vomiting

drugs
- thiazide diuretics

endocrine

  • hypopituitarism
  • primary adrenal insufficiency
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3
Q

ddx for euvolaemic hyponatraemia

A
SIADH
- drugs
- cerebellar pathology
- malignancy
secondary adrenal insufficiency
hypothyroidism

psychogenic polydipsia
pain
nausea

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4
Q

ddx for hypervolaemic hyponatraemia

A

CKD
CCF
Liver cirrhosis
nephritis syndrome

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5
Q

define hyponatraemia

A

< 135mmol/L

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6
Q

define severe hyponatraemia

A

< 120mmol/L

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7
Q

how to examine extracellular volume status in hyponatraemmia

A
  • blood pressure (lying, standing)
  • presence of oedema
  • jugular venous pressure
  • pulse rate
  • skin turgor
  • mucous membrane hydration
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8
Q

diagnostic criteria for SIADH

A

serum Na+ < 130mmol/L
serum osmolality < 275
urine osmolality > 100
urine sodium > 30

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9
Q

what is SIADH, and brief description of its effect

A

syndrome of inappropriate anti-diuretic hormone secretion

  • excess ADH secretion
  • water gets retained in body
  • electrolytes are lost (mainly sodium)
  • > hyponatraemia with high urine salt content
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10
Q

hyponatraemia - indications for hospital management

A

Na+ < 120mmol/L

hyponatraemia with cerebral signs

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11
Q

hyponatraemia - outpatient management

A
  • address the cause of hyponatraemia
  • patient to monitor fluid input, urine output
  • fluid restriction
    day 1 - 0.8-1.2L in 24 hours
    day 2+ - urine output - 500mL
  • daily review with UECs
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12
Q

hyponatraemia treatment - target correction rate

A

10mmol/24h

18mmol/48h

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13
Q

neurological symptoms of hyponatraemia

A
  • altered conscious state
  • dizziness
  • seizure
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