Step 2 CK NBME 8 verified/passed

Step 2 CK NBME 8How does hypernatremia present? - correct answer thirst oliguria or polyuria mental status changes weakness focal neurologic deficits seizures "doughy" skin and signs of volume depletion What are the causes of hypernatremia? - correct answer 6Ds - diuresis - dehydration - diabetes inspidus - docs (iatrogenic) - diarrhea - disease (kidney, sickle cell) How is hypernatremia tx? - correct answer Treat underlying causes and replace free-water deficit w/ hypotonic saline, D5W, or oral water, depending on volume status - correction of chronic hypernatremia (>36-48hrs) should be accomplished gradually over 48-72hrs (</=0.5 mEq/hr) to prevent neurologic damage secondary to cerebral edema How does hyponatremia present? - correct answer may be Asx or may present w/ confusion, lethargy, muscle cramps, hyporeflexia, and nausea Can progress to seizures, coma, or brain stem herniation What are the causes of hypervolemic hyponatremia? - correct answer nephrosis cirrhosis