Today, we're tackling the absolutely mammoth topic of hyponatremia after JAMA recently published a fantastic article about its diagnosis and management.

We start with a review of some relevant physiology before talking about the ways in which hyponatremia can present, and the approach to determining the underlying cause of the hyponatremia.

In this episode, we specifically talk about determining whether the patient has either hypertonic, isotonic or hypotonic hyponatremia, as well as a discussion of the causes of hypertonic and isotonic hyponatremia. From here, we go on to focus on the relevant history and examination when working up a patient with hypotonic hyponatremia in order to further sub classify their hypotonic hyponatremia as being hypovolaemic, euvolaemic or hypervolaemic.

Resources for today's episode:

Diagnosis and Management of Hyponatremia - A Review by Adrogue, H.J., Tucker, B.M. and Madras, N.E. (JAMA)

Hyponatremia StatPearls

Up to Date articles:

• Causes of hyponatremia without hypotonicity
• Causes of hypotonic hyponatremia in adults
• Diagnostic evaluation of adults with hyponatremia
• Overview of treatment of hyponatremia in adults
• Pathophysiology and aetiology of the syndrome of inappropriate antidiuretic hormone secretion (SIADH)
• Treatment of hyponatremia: Syndrome of inappropriate antidiuretic hormone secretion (SIADH) and reset osmostat
• Cerebral salt wasting

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Thanks for listening, and happy studying!