Sodium Imbalances - CRASH! Medical Review Series

(Disclaimer: The medical information contained herein is intended for physician medical licensing exam review purposes only, and are not intended for diagnosis of any illness. If you think you may be suffering from any medical condition, you should consult your physician or seek immediate medical attention.)

[@shipwreck4273]

Epic explanations. Thank you Dr Paul, you’re the teacher I’ve never had. Much respect

[@kennethmathewrey9774]

You are a great teacher Doc!

[@shimamehrizi4645]

Thank you for your informative video. A quick explanation to your question to why we don't use half normal saline or 5% dextrose in patients with hypernatremia is because they are hypotonic solutions. As such they should never be used for initial resuscitation because they quickly exit the intravascular system and consequently will lower the sodium levels too rapidly which could lead to cerebral edema.

[@inchyokk]

also i wud posthulate that you dont give glucose containing solutions for hypernatremia because glucose is osmotically active and would just cause the patient to pass more urine and further concentrate their ECF? Unsure

[@adens_art22]

Nelson book of Paediatrics says that we have to give N/2 with 5% DW

[@bek179]

you have made things so much easier,thanks a lot!

[@vladiovoaia127]

Thank you for the great lecture.

[@funwithme6959]

Thank you so much Dr Bolin!!

[@braedend7446]

Thank you. Great Video

[@yonathanaliyeasfaw1451]

thank you so much doctor...very helpful

[@DrDinooshDeLivera]

Thank you Dr Bolin, really great lectures!

[@adamaltaani4190]

Thanks a lot.

[@juliusl5211]

Thank you so much!

[@valeriewandael73]

Love your videos

[@mohiuddinalfarra5440]

thank you.

[@mawaddasulieman5433]

Many thanks DUde

[@atharyman]

Thank you

[@samamso2155]

very good .

[@tanzhaoxuan4071]

Hi Thank you for your video! May I ask the reason of avoiding glucose -containing fluids to correct hypernatreaemia, is it because it may lead to cerebral oedema if sodium level is corrected too quickly, leading to hyponatraemia?

[@muttiplay]

Couldn't DKA cause dilution hyponatremia?

[@LA_337]

So does psychogenic polydipsia cause a hypervolemic(urinary Na

[@icyulin]

+Aaa di I believe its euvolemic hyponatremia, assuming pt has normal kidneys

[@mitralvalve3141]

I thought that we can give dextrose for hypervolemic hypernatremia can we please someone help !!

[@realtrickybilly]

Question: which digestive juice has more sodium than the blood?
If I understand correctly there have to have more sodium in digestive juices than in the blood since vomiting and diarrhea cause hypovolemic HYPOnatremia . Serum sodium is around 135-145 mEq/L. What has more sodium than the blood? I have looked at one paper at a glance and it seems to me (if I have not messed up something) that they have measeured around 60 mEq/L Na+ in gastric juice in normal people. To get the paper Google: the electrolyte concentration of human gastric secretion. If I did not mess up Google search and unit conversion bile has around 160 mEq/L sodium which is more than 145 mEq/L, but is it enough to do the job?

[@inchyokk]

you get a hypovolemic hyponatremia from GI losses because youre losing both fluid and sodium as well as other electrolytes in vomitus and chronic diarrhoea.

[@minnymoony]

hypoaldosteronism should cause a urine with elevated sodium content. around min 7:30

[@rabbyarehman6543]

I think he means blood plasma - you get low sodium and high potassium in the plasma with hypoaldosteronism. Hope that clarifies

[@maryamkhan2978]

i think the same

[@nastyNizzle34]

in MTB2 book, it says Pneumonia can cause hyperNatremia, do you know why this is?

[@pwbmd]

+nastyNizzle34 That is a really good question. I've honestly never heard about this association. My first inclination would be third spacing of free water resulting in hypovolemic hypernatremia. Infection in general can be associated with SIADH, but that would cause hyponatremia - not hypernatremia.

[@sarahmohammed3938]

I read once that the hyperventilation in pnemonea can really cause hypernaterima (insensible loss) and again for the same reason it can cause hyponaterimea but actually don't get it !! I ended up memorizing a list of causes that don't make any sense at least for me
thank you bro for the amazing effort , your channel has become my resource , way better than any thing else your channel is the BEST hats off

[@hammadmohammad9343]

cant treat SIADH with TOLVAPTAN??

[@rabbyarehman6543]

That's a WRONG answer on USMLE!!!

[@Tenneisa]

Tolvaptan is a vasopressor receptor antagonist that promotes water excretion without the loss of electrolytes. It can be used in hypervolemic and euvolemic hypernatremia. It can be used from what I have understood