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Hyponatremia, Affect laboratory instruments that measure the level of Na+
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Hyponatremia
Concentration of sodium depends of our water concentration
- 60% of body weight from water
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Same osmolarity between 2 compartments:
- Water move freely
- Water follows sodium
Hypovolemic hyponatremia
- Small decrease H2O
- Large decrease Na+
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Cerebral salt waisting
Intra cranial injury (Meningitis) disrupt the sympathetic nervous system of the kidney = disproportionate loss of the sodium
Diarrhea & vomiting
- Na+ in digestive juices are lost
Hypervolemic Hyponatremia
- Large increase H2O
- Small increase Na+
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Edema (ankle) -> Lower circulating volume:
- Antidiuretic H = retain H2O
- Aldosterone = retain na+ = retains h2O
Causes:
- Congestive heart failure
- Cirrhosis
- Nephrotic syndrome
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Treatments
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Severe hyponatremia = Provide Hypertonic saline (but slowly otherwise cerebral pontine myelinolysis)
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Euvolemic hyponatremia
- Increase H2O
- Normal Na+
- No edema
Dilute urine
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Drinking too much
- Water: polydipsia
- Beer: Potomania
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Excess of lipids:
- TG = Hypertriglyceridemia
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Symptoms
Nausea, vomiting, muscle cramps
Severe hyponatremia = <120 mEq/L = Cerebral edema
- Neuron swell with water -> confusion -> coma -> death
- Increased intracranial pressure -> ischemia
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- Gaining more water than sodium
- Losing more sodium than water
Affect laboratory instruments that measure the level of Na+
- Say that Na+ is low but its false