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ELECTROLYTE DISORDERS CRISBERT I. CUALTEROS, MD http://crisbertcualteros.page.tl
HYPONATREMIA ,[object Object]
Generation of Hyponatremia ,[object Object]
Sign and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sign and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostic Approach Hyponatremia Na and Water Deficit Water Excess Na and Water Excess Hypervolemia Hypovolemia Euvolemia
Diagnostic Approach Hyponatremia Hypovolemia Euvolemia Hypervolemia Renal Losses Diuretic excess Mineralcorticoid Deficiency Salt losing nephritis RTA Extrarenal Losses Vomiting Diarrhea Burn Pancreatitis Peritonitis Urine Na >20 Urine Na<10
Diagnostic Approach Hyponatremia Hypovolemia Euvolemia Hypervolemia Glucocorticoid Deficiency Hypothyroidism Pain Emotional Stress Drugs SIADH Urine Na >20
Diagnostic Approach Hyponatremia Hypovolemia Euvolemia Hypervolemia Nephrotic Syndrome Cardiac Failure Cirrhosis ARF CRF Urine Na <10 Urine Na >20
Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Rate of Correction ,[object Object],[object Object],[object Object]
Central Demyelinating Lesion ,[object Object],[object Object],[object Object],[object Object],[object Object]
Risk Factor for Demyelination ,[object Object],[object Object]
HYPERNATREMIA ,[object Object]
Generation of Hypernatremia ,[object Object]
Sign and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostic Approach Hypernatremia Na and H2O Deficits H2O losses Na Addition Excess Hypovolemia Euvolemia Hypervolemia
Diagnostic Approach Hypernatremia Hypovolemia Euvolemia Hypervolemia Renal losses Osmotic and loop diuretics Post obstruction Extrarenal Losses Sweating Burns Diarrhea Urine Na >20 Urine Na <10
Diagnostic Approach Hypernatremia Hypovolemia Euvolemia Hypervolemia Renal Losses Nephrogenic DI Central DI Extrarenal Losses Respiratory and Dermal Incensible Losses Urine Na = Variable Urine Na = Variable
Hypernatremia Hypovolemia Euvolemia Hypervolemia Primary Hyperaldoteronism Cushing’s Syndrome Hypertonic Dialysis Hypertonic NaHCO3 NaCl tablets Urine Na >20 mEq/L
Treatment ,[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object]
Water Replacement ,[object Object],[object Object],[object Object],[object Object]
HYPOKALEMIA ,[object Object]
Sign and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sign and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object]
Sign and Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object]
Causes ,[object Object],[object Object],[object Object],[object Object],[object Object]
Causes ,[object Object],[object Object],[object Object],[object Object],[object Object]
Causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Diagnostic Approach Hypokalemia Redistribution Extrarenal U K <20 Renal loss U K >20 Metabolic acidosis Diarrhea GI fistulas Laxative abuse Normal Acid-Base Profuse sweating Laxative abuse Gastric fistula Previous vomiting
Diagnostic Approach Hypokalemia Redistribution Extrarenal Loss U K <20 Renal Loss U K >20 Hypertensive High Plasma Renin Malignant HPN Renovascular HPN Renin secreting tumors Low Plasma Renin Primary Aldosteronism Cushing’s Syndrome Adrenal hyperplasia
Diagnostic Approach Hypokalemia Redistribution Extrarenal Loss U K <20 Renal Loss U K >20 Normotensive Metabolic Alkalosis U Cl <10 Vomiting U Cl >10 Diuretics Mg Depletion Barter syndrome Gittleman syndrome
Diagnostic Approach Hypokalemia Redistribution Extrarenal Loss U K <20 Renal Loss U K >20 Normotensive Metabolic acidosis Normal Anion Gap RTA Increase Anion Gap Diabetic Ketoacidosis Ethylene Glycol
Treatment ,[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object]
HYPERKALEMIA ,[object Object]
Etiology of Hyperkalemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology of Hyperkalemia ,[object Object],[object Object],[object Object],[object Object],[object Object]
Etiology of Hyperkalemia ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Sign and Symptoms ,[object Object],[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object],[object Object]
Treatment ,[object Object],[object Object],[object Object],[object Object]
 

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ELECTROLYTE DISORDERS

  • 1. ELECTROLYTE DISORDERS CRISBERT I. CUALTEROS, MD http://crisbertcualteros.page.tl
  • 2.
  • 3.
  • 4.
  • 5.
  • 6. Diagnostic Approach Hyponatremia Na and Water Deficit Water Excess Na and Water Excess Hypervolemia Hypovolemia Euvolemia
  • 7. Diagnostic Approach Hyponatremia Hypovolemia Euvolemia Hypervolemia Renal Losses Diuretic excess Mineralcorticoid Deficiency Salt losing nephritis RTA Extrarenal Losses Vomiting Diarrhea Burn Pancreatitis Peritonitis Urine Na >20 Urine Na<10
  • 8. Diagnostic Approach Hyponatremia Hypovolemia Euvolemia Hypervolemia Glucocorticoid Deficiency Hypothyroidism Pain Emotional Stress Drugs SIADH Urine Na >20
  • 9. Diagnostic Approach Hyponatremia Hypovolemia Euvolemia Hypervolemia Nephrotic Syndrome Cardiac Failure Cirrhosis ARF CRF Urine Na <10 Urine Na >20
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.
  • 16.
  • 17. Diagnostic Approach Hypernatremia Na and H2O Deficits H2O losses Na Addition Excess Hypovolemia Euvolemia Hypervolemia
  • 18. Diagnostic Approach Hypernatremia Hypovolemia Euvolemia Hypervolemia Renal losses Osmotic and loop diuretics Post obstruction Extrarenal Losses Sweating Burns Diarrhea Urine Na >20 Urine Na <10
  • 19. Diagnostic Approach Hypernatremia Hypovolemia Euvolemia Hypervolemia Renal Losses Nephrogenic DI Central DI Extrarenal Losses Respiratory and Dermal Incensible Losses Urine Na = Variable Urine Na = Variable
  • 20. Hypernatremia Hypovolemia Euvolemia Hypervolemia Primary Hyperaldoteronism Cushing’s Syndrome Hypertonic Dialysis Hypertonic NaHCO3 NaCl tablets Urine Na >20 mEq/L
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32. Diagnostic Approach Hypokalemia Redistribution Extrarenal U K <20 Renal loss U K >20 Metabolic acidosis Diarrhea GI fistulas Laxative abuse Normal Acid-Base Profuse sweating Laxative abuse Gastric fistula Previous vomiting
  • 33. Diagnostic Approach Hypokalemia Redistribution Extrarenal Loss U K <20 Renal Loss U K >20 Hypertensive High Plasma Renin Malignant HPN Renovascular HPN Renin secreting tumors Low Plasma Renin Primary Aldosteronism Cushing’s Syndrome Adrenal hyperplasia
  • 34. Diagnostic Approach Hypokalemia Redistribution Extrarenal Loss U K <20 Renal Loss U K >20 Normotensive Metabolic Alkalosis U Cl <10 Vomiting U Cl >10 Diuretics Mg Depletion Barter syndrome Gittleman syndrome
  • 35. Diagnostic Approach Hypokalemia Redistribution Extrarenal Loss U K <20 Renal Loss U K >20 Normotensive Metabolic acidosis Normal Anion Gap RTA Increase Anion Gap Diabetic Ketoacidosis Ethylene Glycol
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42.
  • 43.
  • 44.
  • 45.
  • 46. Â