Hyponatraemia Flashcards

1
Q

Approaching electrolyte abnormalities

A

Symptoms
Severity
Timeline
Intravascular volume

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2
Q

Symptoms

A
Confusion mod
Nausea 
Vom severe
Seizures
LOC
Cerebral oedema
Coma, Resp arrest, Death
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3
Q

Insidious confusion

A

Chronic hyponatraemia

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4
Q

Severity

A

<135 mild
<130 moderate
<125 severe

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5
Q

Chronic hyponatraemia

A

Risk of poor outcome if correction is too quick

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6
Q

Timeline

A

Is it acute or chronic?

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7
Q

Determining fluid status

A

In exam:
Dry-> hypovolaemic
Normal -> euvolaemic
Wet -> hypervolaemia

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8
Q

Urine

A

Check urine sodium
Paired osmolality:
Check urine osmolality + blood osmolality

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9
Q

High blood osmolality

A

Lab mistake: with lots of fat/protein/Ig

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10
Q

High blood sodium

A

.?

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11
Q

Serum osmolality

A

Should be 275 - 295 normally

Should be low if hyponatraemic

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12
Q

Hypovolaemic causes

A

.?

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13
Q

Diuretics which cause hyponatraemia

A

Thiazides diuretics -> stop diuretic allow it to increase alone

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14
Q

Management of severe acute hyponatraemia

A

3% saline
Check again in an hour
4-6 mmol increase in a few hours
No >10 in trust 24 hrs!!

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15
Q

Osmotic demyelination syndrome

Central pontine demyelination

A
If sodium rises too quickly
Confusion
Dysarthria
Dysphasia
Locked in syndrome
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16
Q

Euvolaemic hyponatraemia

A

SIADH:
high urine osm >100
Hyperthyroidism

17
Q

Common causes

A

Diarrhoea vom
Thiazides
SIADH
Cirrhosis HF