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.
@inchyokk5 жыл бұрын
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_art224 жыл бұрын
Nelson book of Paediatrics says that we have to give N/2 with 5% DW
@shipwreck42734 жыл бұрын
Epic explanations. Thank you Dr Paul, you’re the teacher I’ve never had. Much respect
@kennethmathewrey97748 жыл бұрын
You are a great teacher Doc!
@bek1797 жыл бұрын
you have made things so much easier,thanks a lot!
@tanzhaoxuan40716 жыл бұрын
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?
@funwithme69595 жыл бұрын
Thank you so much Dr Bolin!!
@DrDinooshDeLivera5 жыл бұрын
Thank you Dr Bolin, really great lectures!
@vladiovoaia1276 жыл бұрын
Thank you for the great lecture.
@juliusl52113 жыл бұрын
Thank you so much!
@yonathanaliyeasfaw14515 жыл бұрын
thank you so much doctor...very helpful
@LA_3378 жыл бұрын
So does psychogenic polydipsia cause a hypervolemic(urinary Na
@icyulin8 жыл бұрын
+Aaa di I believe its euvolemic hyponatremia, assuming pt has normal kidneys
@minnymoony7 жыл бұрын
hypoaldosteronism should cause a urine with elevated sodium content. around min 7:30
@rabbyarehman65436 жыл бұрын
I think he means blood plasma - you get low sodium and high potassium in the plasma with hypoaldosteronism. Hope that clarifies
@maryamkhan29786 жыл бұрын
i think the same
@samamso21555 жыл бұрын
very good .
@braedend74468 жыл бұрын
Thank you. Great Video
@mitralvalve3141 Жыл бұрын
I thought that we can give dextrose for hypervolemic hypernatremia can we please someone help !!
@mawaddasulieman54335 жыл бұрын
Many thanks DUde
@valeriewandael733 жыл бұрын
Love your videos
@adamaltaani41907 жыл бұрын
Thanks a lot.
@mohiuddinalfarra54406 жыл бұрын
thank you.
@atharyman8 жыл бұрын
Thank you
@realtrickybilly7 жыл бұрын
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?
@inchyokk5 жыл бұрын
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.
@muttiplay6 жыл бұрын
Couldn't DKA cause dilution hyponatremia?
@nastyNizzle348 жыл бұрын
in MTB2 book, it says Pneumonia can cause hyperNatremia, do you know why this is?
@pwbmd8 жыл бұрын
+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.
@sarahmohammed39387 жыл бұрын
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
@hammadmohammad93438 жыл бұрын
cant treat SIADH with TOLVAPTAN??
@rabbyarehman65436 жыл бұрын
That's a WRONG answer on USMLE!!!
@Tenneisa5 жыл бұрын
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