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Hypernatremia, Rare case: person has a image to the hypothalamus, ADH…
Hypernatremia
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Concentration of sodium depends of our water concentration
- 60% of body weight come from water
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Same osmolarity between 2 compartments:
- Water move freely
- Water follows sodium
Clinical manifestations
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- Long standing hypernatremia = fewer symptoms
- Acute hypernatremia = altered mental status, seizures, coma
Diagnosis
Hypovolemic
- Drink too little water/sweating a lot
- Kidneys retains water = concentrated urine
Euvolemic
- Kidneys dump water (Diabetes insipidus)
- Diluted urine
water loss:
- Sweat
- Moisture in breath
- Fever+++
- Exercise+++
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Sodium gain
- Intravenous sodium (if too much = cerebral edema)
- Too much salt in diet
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High concentration in sodium in the blood
- Above 145mEq/L
- Guide water out of the cell
- Losing more water than sodium = CDI
- Gaining more sodium than water
- Develop over time = Cells adapt and create osmotically active particle = prevent water from being lost via osmosis
- Develops acutely = No time to adapt, cells shrivels and dies
Rare case: person has a image to the hypothalamus, ADH don't get released and thirst center get destroyed