Diagnoses
To diagnose hyponatremia, name 1 relevant question to ask during the patient's history, and name 1 laboratory test that should be ordered.
Answers vary: History of fluid loss, history of hyponatremia, drug use, PMH, complete metabolic panel (lytes, etc.), urine/serum osmolality, urine sodium levels.
What is one major complication of hyponatremia?
Seizures
True or false: The rate of correction for hyponatremia is 4-8 mmol/L in a 24h period.
False. It is 4-6 mmol/L in a 24h period.
In a patient with suspected SIADH, which of the following findings supports the diagnosis?
A. Hypernatremia with high plasma osmolality
B. Hyponatremia with low urine osmolality
C. Hyponatremia with high urine osmolality
D. Hypokalemia with low urine osmolality
C. Hyponatremia with high urine osmolality. In SIADH, hyponatremia is accompanied by high urine osmolality as the kidneys concentrate urine despite low plasma osmolality due to inappropriate ADH secretion.
True or false: Headache and nausea are potential early symptoms of hyponatremia.
True.
What would be the most appropriate initial treatment in managing a patient with severe hyponatremia due to SIADH?
Administering 3% saline.
A 45-year-old patient presents with weakness, fatigue, and hyponatremia with hyperkalemia. Lab results show low cortisol levels and elevated ACTH. Based on these findings, what is the most likely diagnosis, and what additional lab test would you order to confirm the diagnosis?
Addison's disease (Primary adrenal insufficiency)
Confirmation test: ACTH stimulation test
Which symptom in SIADH is most likely due to cellular swelling in the brain?
A) Nausea
B) Tremors
C) Peripheral edema
D) Confusion
D) Confusion. Hyponatremia leads to water shifting into cells, including brain cells, causing cerebral edema and neurological symptoms like confusion.
Name 2 goals of hyponatremia treatment.
Answers vary: Prevent further decline in serum sodium, prevent neurological complications, relieve symptoms of hyponatremia, avoid excessive correction of hyponatremia.