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Hypernatremia (Clinical
presentation (Lethargy, Weakness, Thirst,…
Hypernatremia
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Aetiology
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Endocrine
Primary aldosteronism (Conn's)
DKA, HHS (osmotic diuresis)
Diabetes insipidus (head injury, surgery)
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Diagnosis
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Investigations
Bloods
FBC, U+E (Na high), LFTs,
glucose (DKA, HHS), serum Osm
Urine
Urine Osm (usually hypertonic, hypo in DI)
Na conc
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History
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PMH
Endocrine disorder e.g. Conns, DI, DM
SH
Living arrangements, occupation,
smoking, alcohol, drugs
PC/HPC
Lethargy, thirst, weakness,
confusion, seizures, coma
recent acute illness
Management
Definitive
Medical
if normovolemic, IV glucose 5% slowly
If hypovolemic, IV 0.9% saline
(will be hypotonic in a hypertonic patient!)
Avoid hypertonic solutions (will dehydrate more)
Conservative
Information, advice, support
Identify and tx cause
PO water if possible
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