Hypovolumic Hypernatremia - USMLE Forums
USMLE Forums Logo
USMLE Forums         Your Reliable USMLE Online Community     Members     Posts
Home
USMLE Articles
USMLE News
USMLE Polls
USMLE Books
USMLE Apps
Go Back   USMLE Forums > USMLE Step 2 CK Forum

USMLE Step 2 CK Forum USMLE Step 2 CK Discussion Forum: Let's talk about anything related to USMLE Step 2 CK exam


Reply
 
Thread Tools Search this Thread Display Modes
  #1  
Old 05-02-2010
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 247
Threads: 61
Thanked 273 Times in 105 Posts
Reputation: 303
Emergency Hypovolumic Hypernatremia

In hypovolumic hypernatremia ....
Kaplan both in book and qbank said : give 5% dextrose and half(.45%) normal saline .... here in ques its due to excessive diuresis .. than intake ... hypo hyperNa
In UW : normal (.9%) saline is fluid of choice for initial Rx ... here due to diarrhea in a child ....
Tho both are are hypovolumic HyperNa
So i am confused cause ... can someone please explain this thing ... thank u
Reply With Quote Quick reply to this message



  #2  
Old 05-02-2010
ath.pantelis's Avatar
USMLE Forums Addict
 
Steps History: 1+CK+CS
Posts: 187
Threads: 4
Thanked 368 Times in 121 Posts
Reputation: 398
Default

I think that first of all we have to assess hypovolemia. If there are true signs of hypovolemia, I think that this topic should be addressed first, because correcting the extracellular fluid volume will lead to correction of sodium concentration. So, in a pt with apparent signs of hypovolemic shock I would administer normal saline.

If the pt is euvolemic (and even worse hypervolemic), there is a considerable risk of volume overload, which would secondarily lead to edema (pulmonary, anasarca, heart congestion etc). In this case, I think the appropriate management should involve D5W & 1/2NS, in order to cause osmotic diuresis & consequent natriuresis at the same time.
Reply With Quote Quick reply to this message
The above post was thanked by:
FSUSTC (05-09-2010), Ronald (05-02-2010), Sabio (05-02-2010)
  #3  
Old 05-09-2010
USMLE Forums Veteran
 
Steps History: 1+CK+CS+3
Posts: 247
Threads: 61
Thanked 273 Times in 105 Posts
Reputation: 303
Default

I have got a answer in UW about this ques and it really make sense ...
1. If hypernatremia with hypotension ... best initial .9 % nacl ... and when pt stabilize start .45% nacl
2. If hypernatremia without hypotension .... best initial is .45 % nacl

U r right ath.pentelis .... best initial depends on volumia either hypo or eu ...
Reply With Quote Quick reply to this message
The above post was thanked by:
ath.pantelis (05-10-2010)



Reply

Tags
Emergency-Medicine, Internal-Medicine-

Quick Reply
Message:
Options

Register Now

In order to be able to post messages on the USMLE Forums forums, you must first register.
Please enter your desired user name, your email address and other required details in the form below.
User Name:
Password
Please enter a password for your user account. Note that passwords are case-sensitive.
Password:
Confirm Password:
Email Address
Please enter a valid email address for yourself.
Email Address:
Medical School
Choose "---" if you don't want to tell. AMG for US & Canadian medical schools. IMG for all other medical schools.
USMLE Steps History
What steps finished! Example: 1+CK+CS+3 = Passed Step 1, Step 2 CK, Step 2 CS, and Step 3.

Choose "---" if you don't want to tell.

Favorite USMLE Books
What USMLE books you really think are useful. Leave blank if you don't want to tell.
Location
Where you live. Leave blank if you don't want to tell.

Log-in

Human Verification

In order to verify that you are a human and not a spam bot, please enter the answer into the following box below based on the instructions contained in the graphic.



Thread Tools Search this Thread
Search this Thread:

Advanced Search
Display Modes


RSS Feed
Find Us on Facebook
vBulletin Security provided by vBSecurity v2.2.2 (Pro) - vBulletin Mods & Addons Copyright © 2017 DragonByte Technologies Ltd.

USMLE® & other trade marks belong to their respective owners, read full disclaimer
USMLE Forums created under Creative Commons 3.0 License. (2009-2014)