U + E physiology and pathology bitches!!!!

Question 1

What is hypernatraemia?

Answer 1

• Hypernatraemia is defined as a serum sodium concentration exceeding 145 mmol/L → too much salt in the blood. • Hypernatremia is a “water problem,” not a problem of sodium homeostasis.

Question 2

What are the symptoms of hypernatraemia?

Answer 2

• Lethargy • Thirst • Irritability • Confusion • Fits • Coma • Signs of dehydration

Question 3

What is the treatment for hypernatraemia?

Answer 3

• Oral H20 • if not, Glucose • 0.9% saline in hypovolaemia

Question 4

What are the causes associated with hypernatraemia?

Answer 4

Usually due to loss of H20 > NaCl : • Fluid loss with no H20 replacement → Diarrhoea, burns, vomit. • Diabetes insipidus → Large urine volume • Osmotic diuresis • Primary aldosteronism • Iatrogenic → Excess saline given.

Question 5

What is HYPOnatraemia?

Answer 5

• Hyponatremia is an electrolyte abnormality that can be seen in isolation or, as most often is the case, as a complication of other medical illnesses. • It is defined as a serum sodium Lvl <135

Question 6

What are the signs and symptoms of Hyponatraemia?

Answer 6

Initially: • Anorexia, Nausea, Malaise. Followed by: • Headache, Irritability, confusion, weakness, ↓GCS, and seizures Cardiac failure or oedema may help indicate cause.

Question 7

What are the causes of Hyponatraemia when urinary sodium is greater than 20mmol/l ?

Answer 7

In this scenario Na+ and H20 are lost via the kidneys: • Addisons disease • Renal failure: diuretic phase of renal failure, Nephrocalcinosis or medullary cystic disease. • Diuretic excess • Osmolar diuresis