updated hypernatremia

Question 1

what are the causes of hypernatremia ?

Answer 1

either fall unddeer waterr loss or salt gain

Question 2

if the causes of hypernatremia and hyponatremia are the same what differentiates them ?

Answer 2

if the patient drinks enough water - it’s hyponatremia
if the patient doesn’t drink enough water - hypernatremia

Question 3

at what level of sodium is the patient considered to have hypernatremia ?

Answer 3

above 145

Question 4

what is. thr presentation of hypernatmia ?

Answer 4

either
acute : CNS symptoms , confusion ,headache, nausea and vomiting , seizured, coma
chronic : usually asymptomatic

Question 5

what ar the causes of water loss that ccan causee hypeernatremia ?

Answer 5

insensible losses - sweating, burns, fever
gastrointeestinal loss - vomiting, diarrhea
renal loss - polyuria duee to osmotic diuresis, diabetes insipidus

Question 6

what are the causees of osmotic diuresis ?

Answer 6

DKA
diureticcs

Question 7

what are the types of diabetes insipidus ?

Answer 7

central diabetes insipidus : ADH release by the posterior pituitary
nephrogenic diabetes insipidus : normal release of ADH but with a decreased rrenal tubules response

Question 8

what is thee effect of ADH ?

Answer 8

reabsorbs water in the distal convoluted tubules
whilst aldosterone in the proximal convoluted tubule

Question 9

what are the causes of sodium gain that cause hyprnatremia ?

Answer 9

primary hyperaldosteronism
cushing syndrome

Question 10

what are the diseases that cause sodium gain and hence hypernatremia ?

Answer 10

conn’s syndrome - due to tumor in the adrenal cortex, an increase in aldosterone
cushing syndrome - increase in cortisol

Question 11

what is the electrolyte imbalance that happens in conn’s syndrome and cushing syndrome ?

Answer 11

hypernatremia
hypokalemia
metabolic alkalosis

Question 12

what are the common causes of nephrogenic diabetes insipidus ?

Answer 12

lithium
sickle cell disease
chronic kidney disease

Question 13

what is tthe treatment for hypernatremia ?

Answer 13

if the cause is due to water loss - then increase water intake by giving 5% dextrose orr orall water and then treat the cause

Question 14

what is the treatment for central diabetes insipidus ?

Answer 14

give vasoprressin

Question 15

what would be the treatment for sodium gain associated with hypernatremia ?

Answer 15

diuretics
and then increase water intake by giving 5% dextrose or oral water
then threat the cause

Question 16

what are the causes of central diabetes insipidus ?

Answer 16

idiopathic
trauma
tumor
neurosurgery
infection