Table of Contents:
How Endurance Athletes Can Avoid Hyponatremia
Video taken from the channel: EndurElite
Hyponatremia Explained Clearly Symptoms, Diagnosis, Treatment
Video taken from the channel: MedCram Medical Lectures Explained CLEARLY
Hyponatremia
Video taken from the channel: Strong Medicine
Exercise Induced Hyponatremia
Video taken from the channel: PatientEducation.Video
Hyponatraemia (Hyponatremia) classification, causes, pathophysiology, treatment
Video taken from the channel: Armando Hasudungan
Electrolyte Imbalances | Hyponatremia (Low Sodium)
Video taken from the channel: Simple Nursing
Experts: Overhydration Potentially Deadly for Athletes
Video taken from the channel: Medicine Virginia
Hyponatremia is a condition that usually and frequently affects athletes. The main issue is that, on many occasions, it’s complicated to make a diagnosis and name all the annoying symptoms that athletes suffer from. That’s why it’s essential to learn about this health issue.
The early signs of hyponatremia are very subtle and may look similar to dehydration and can cause confusion, Slurred speech, and disorientation. Many athletes start drinking more water at this point because they have mistaken it for dehydration. Water creates further more problems in the body. In extreme cases, the athlete can also die.Unfortunately, water alone will increase the problem of hyponatremia.
At the most extreme, an athlete may experience seizures, coma, or death. Treatment. At the first sign of symptoms, an athlete should drink a sodium containing sports drink such as Extreme Hydration Formula and avoid those with too much sugar and fillers. Ideally, an athlete should plan ahead and estimate his or her fluid loss and need for sodium replacement.
In more serious cases, excess fluid is pushed out of the blood vessels and into the cells, causing puffy fingers and ankles—picture the edema experienced by many athletes at the end of an endurance event. Extreme hyponatremia can begin to affect the brain, resulting in seizures, coma, or even death.What You Need to Know About Hyponatremia www.runnerclick.com There was a time when dehydration was thought to be one of the biggest risks of long distance running. As a result, runners were encouraged to drink specified amounts of fluid per unit of time, regardless of whether they felt thirsty. Which, in hindsight, had disastrous consequences.
adaptations are the reports of dilutional hyponatremia. The endurance. athlete requires approximately 10-14 days training in exposure to similar. heat and humidity as imposed during an event that lasts 3-6 hours in. length at an exercise pace of 75-85% VO2 Maximum Heart Rate. If 10-14 days.
What causes hyponatremia? Hyponatremia happens when too much sodium leaves your body, or when more water than sodium stays in your blood. Any of the following conditions can lead to hyponatremia: A diet that is low in sodium; Drinking too much water or receiving too much fluid through an IV; Intense and prolonged exercise that causes excessive sweating.Endurance athletes are at particular risk of hypernatremia and hyponatremia. Athletes lose electrolytes through sweat but maintaining sodium balance is clearly key to optimal physical performance.
For particularly hot sessions – either indoors on the turbo or.Hyponatremia is a dangerous condition of low blood sodium concentration that can occur during exercise. Most cases of hyponatremia are due to over-consuming water and sports drinks during exercise, and are more common in athletes taking more time to complete endurance events.Above all, the history of hyponatremia and the patient’s most recent previous serum sodium level are essential to know.” Acute hyponatremia—defined as having started within 48 hours—merits rapid correction with hypertonic saline to prevent brain herniation, according to a joint guideline issued by European societies in 2014.
Determining sweat rate and sweat sodium content is a good first place to start. If these are high and salty, then the athlete can be predisposed to hyponatremia during long exercise session.Hyponatremia again hit the headlines fairly recently with the publication of data 1 on the prevalence of the condition in IRONMAN finishers in Europe. Worryingly, over 10 percent of athletes tested in a study conducted over the last eight or so years had hyponatremia at.
The primary cause of hyponatremia in athletes is drinking too much water. The incidence of hyponatremia appears to be between 13% and 15% among endurance athletes. Sodium supplementation has no effect on the occurrence of hyponatremia. There seems to not be a single case of death resulting from sports-related dehydration in the medical literature.
There are a few different causes of the condition, but the one of interest to athletes is when dilution of sodium levels in the blood is driven by excessive drinking. This can be exacerbated by the loss of sodium in sweat during prolonged exercise. This variant of the condition is known as ‘Exercise Associated Hyponatremia’, or EAH.
Incidence. Until recently, the incidence of hyponatremia during endurance exercise was unknown and thought to be relatively uncommon. However, recent studies have shown that endurance athletes not uncommonly develop hyponatremia at the end of the race, usually in the absence of clear central nervous system symptoms (9,10,12,15–25).For example, in the 2002 Boston Marathon, Almond et al.
List of related literature:
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| from Williams’ Essentials of Nutrition and Diet Therapy E-Book |
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| from Wilderness Medicine E-Book: Expert Consult Premium Edition Enhanced Online Features |
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| from Advanced Sports Nutrition |
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| from Practical Applications In Sports Nutrition BOOK ALONE |
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| from Visualizing Nutrition: Everyday Choices |
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| from Practical Applications in Sports Nutrition |
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| from Sports Nutrition for Health Professionals |
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| from Nutrition: Science and Applications |
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| from Sports Science Handbook: A-H |
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| from Discovering Nutrition |
128 comments
And I will carry your legacy as the last. my toast is on you good friend, see you soon.
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SIADH vs Diabetes Insipidus https://youtu.be/hKFGGv0E-5A
would you say y axis is na concentration instead of na? so the area is (na/h20)xh20 which make more sense? good video btw, thnk u!
5:12 I’m experiencing but I wanna wait a day before going in to the doctor’s my pee has been clear for 6 months some times in the morning in comes out yellow but later on in the day it will return clear and when I drink water I’m still dehydrated
Could low sodium cause extreme ticks of seizures like, you could be sitting perfectly fine but then out of the blue have a extreme jerk attack and nearly fall out of your chair and it repeats every 5 minutes or less.
thanks doctor for your nice lectures which i watch every other time to refresh my knowledge. i would like to ask you 3 questions if your time allow:
1. if pt present with severe symptoms despite being hyperovlemic (pulmonary edema, ascites or renal failure for example), in this case shall i treat the cause specifically (diuretics or dialysis) without initiating the hypertonic saline?
2. when initially correcting the severe symptoms (seizure for example) and raise sodium say by 3 when symptoms resolve; shall i subtract this value so that the allowed amount for me now to raise over 24 hrs id 3?
3. if pt with cirrhotic ascites come with hyponatremia and hypovolemic, in such case, shall i resuscitate with NS plus managing the ascites with diuretics or total paracentesis?
Hello I signed up for free trial for this site and i cannot view vids for fluids and Electrolytes that says private on youtube. Instead all I am getting is a 10 sec video with a giant lock. Free trial so I know what I am getting into but if I cannot even view the videos that is private on youtube, and get more videos on youtube why should I pay to join this site??????????????
This was definitely a life saver! Currently prepping for the fluids and electrolytes section of my exam����⚕️������
they are asking if the patients eyes are wet or dry?ha ha. teachers are sick. now plz you tell me.how the patients eyes wet or dry?
Hi Mark, I took a laxative called sodium picosulfate and since then I am experiencing lots of water retention, cramps, muscle pain and weakness, insomnia.
My guess is hyponatremia and hypokalemia.
I went to doctors here in Mexico but they are not familiarized, what can I do? Ingest more salt?
Please help
at 2:44 units of osmolality is mosm/kg and not what is stated!
Taking magnesium when your adrenals are struggling can also cause sodium to plummet.
Hey i have a question… I thought that the thiazide diuretics were potassium sparing and loop were postassium wasting?
Thanks for ur response, plz continue to upload other general topics which will benefit both internists and surgeons, appreciate all your hard work. Looking forward to endless hours of such informative lectures.
Sutirtha
India
i just wanted to clarify that hyperglycaemia does not cause pseudonatremia, it causes a hypertonic hypernatremia
sir, please make a video on the topic of hypo & hyperkalemia
I knew I was gonna get it when I click on this. Brilliant teacher ��. You can break things down so well.
I have a patient’s question. I walka lot both in my avocation and backpacking, walking locally instead of transport.I log @ 50 miles a week @ 66 years. I am well aware of hyponatremia. I am facing boutique ‘smart water’ expensive electrolyte powders and capsules and home made brews with lemon juice, ‘Himalayan pink salt’a rip off, apple cider vinegar.
Is there a worthwhile product or formulation? Can I support my needs with diet? I’ve noticed dates, a traditional desert food staple has as much calcium and potassium as the above powders. I pack them with filtered water and salted nuts.
What if both Potassium and sodium are low with Potassium being critically low?
Thanks for the feedback. I know many of my viewers are non-native English speakers. I try to balance between speaking slower so people can understand, without speaking too slowly and making an already long video even longer. I’ve tried to improve the audio quality over the last 2 years, predominantly to help the non-native English speakers, and I include more text on each slide than I do when teaching in person in the US. It’s not perfect for everyone, but it’s the best balance I can do.
I thought kidneys have Na+/HCO3 cotransporter, so both Na+ and HCO3are reabsorbed into bloodstream from tubules. This would help the low Na+ situation, right? The only reason for hyponatremia from vomiting is from the initial loss of electrolytes (including Na+) in the vomit, right…?:/
I have Hypervolemic Hyponetremia as my body wastes sodium seemingly to childhood nutrient deficiency and I drink so much water. I’ve even became vegan eating so much nutrients is there anyway this condition can be reversed naturally?
Hello!!! There is only one thing I finf difficult understanding. Congestive HF, Liver Cirrhosis cause Hypotension and as such the first mechanism to be activated to increase blood volume shouldn’t it be the RAAS?
I wanted to clarify. Hyponaturaemia is incorrect spelling. I apologise. It should be “Hyponatraemia” or “Hyponatremia”.
Aside from the spelling the physiology does not change
HI DR Eric BRILLIANT AND COMPREHENSIVE EXPOSITION AND ILLUSTRATION OF SODIUM POTASSIUM AND WATER HOMOEOSTASIS.what about the distal delivery of sodium in this scenario and implications
Thanks for the video, excellent work as always. One note though: pseudohyponatremia due to hyperlipemia only happens when measuring Na in serum indirectly. Direct ISE (ion selective electrode) methods are not impacted by this.
Great work on a favourite topic of mine! A couple of interesting additions if you don’t mind:
the rate of serum sodium correction is largely determined by free water loss from the kidneys (mediated by ADH). Unfortunately this is very difficult to predict in the symptomatic patient and will almost always lead to an over correction of sodium levels. The ‘desmopressin clamp’ technique prevents free water loss from the kidneys, allowing for accurate correction over time. In many centres this is the standard of care in management of hypernatraemia. It can also be used to reverse and even re-lower sodium in the case of the rapidly over corrected patient. For more information on that, see here: https://emcrit.org/pulmcrit/taking-control-of-severe-hyponatremia-with-ddavp/
Central Pontine Myelinolitis has now had its terminology changed to Osmotic Demyelination Syndrome, which more accurately describes the nature of the condition which is not always limited to the pontine region. Note that this is an exceptionally exceptionally rare condition and usually occurs in those with poor premorbid function with serum sodiums less than 115. Most interestingly, symptoms don’t present for up to 7 days following rapid correction of sodium. I.e. even if you are the doctor that causes it in the ED, you are unlikely to see the outcome due to the patient being admitted elsewhere.
For more information check out EmCrit’s excellent podcast on this topic https://podcasts.apple.com/au/podcast/emcrit-podcast-critical-care-and-resuscitation/id314020330?i=1000431448268
Thanks again for this excellent video!
Tanks for this video..pls keep making contents like this…it helps me a lot..
learnwiko also have stuffs like these… pls check and like back
https://m.youtube.com/channel/UCRjbdlSGw0rsSfP7kuLGR1w
Thanks for the suggestion! I’ve looked at a couple of platforms for delivering content on-line in a more robust fashion than YouTube, but despite their huge support and publicity, I haven’t felt completely convinced of their effectiveness yet. Plus, most invite their course creators (not the other way around), and the type and purpose of content I try to deliver works best if it’s on-demand. Not to say I wouldn’t be interested if Coursera gave me a call…
I have BP 149/98, and sodium 134, I feel very sleepy, it is very hard to drive 2,3 miles.? If I take salt, that may increase BP high. What should I do? Suggest me pls
8:45 Could you explain how in theory fluid deprivation would correct a reset osmostat hyponatremia? Wouldn’t that cause more ADH release via hypotension and thus make hyponatremia more severe?
Great lecture! 7:33 the table mentions cyclosporine, but you say cyclophosphamide; it’s actually cyclophosphamide right?
Isnt corrected sodium equation in dka has 1.6 as multiplication factor @ Strong medicine
Thanks once again for this great content!
I have a question though regarding Step 3 in the Diagnosis Process. How can I reliably determine a patient’s volume status? Hypervolemic might be easy due to odema, but what about differentiating between hypoend euvolemic?
Thank you
Bloody hell this IMO is one of the most complicated topics in Medicine… Thank you! I’m taking some time to proccess all that information
Does this has a part two? Is there is a video on management?
Very complete and helpful!!!!!! Thank you so much. Greetings from Argentina
I remember having heard a lecture by Conrad Fischer where he put a lot of stress on the fact that THE CONCENTRATION OF SODIUM IN URINE and Sweat CANNOT BE MORE THAN THE CONCENTRATION OF SODIUM IN BLOOD The hyponatremia is actually caused due to drinking water.
This made sense as far as sweating and Urine is considered
BUT DOES THE PERSON ALSO FEEL THIRSTY IN CIRRHOSIS AND CONGESTIVE HEART FAILURE.
Have endocrine and urogenital exams next week and didn’t understand the aquaporins and natremia and the T3 T4 effect on heart in Physiology til I watched this video now I know all the Physiology
Thanx alot god bless u ������
It’s really amazing the way you teaching medicine through those videos, perhaps I would love to see more videos and can you post more topics and frequently.
Some endocrinology topics please
Thank you so much for all your videos Dr.strong!
I have a question about a situation in which the patient is symptomatic but his hyponatremia is chronic. Do we still need to correct the sudium slowly? On one hand he is symptomatic, on the other handrapid correction can cause osmotic demyelination syndrome..
I think you meant to say “normal or high” at 16:00.
Many thanks!
Great way of explaination. Easier to understand and grasp the concept. Thank you for the diagram n note map.
this is amazing:) thanks so much for this great effort!:D
I do wonder if anyone who already has seizures should be cautious when working out (careful not to provoke seizures for them) because I do exercise and do wonder if this can happen if one isn’t to careful or over does things I am cautious however when doing so and also just a tip if one is in a gym and has epilepsy it is helpful to let staff know if you do have any medical conditions that way if you were to have something happen they can respond properly if that were the case
Great video. One error though, at baseline [Na] is not equivalent in ICF and ECF. Na is mostly an ECF ion.
Please >> any handout available for teaching purpose??? so many thanks
Just want to say a big Thank You Dr. Strong, for all your videos! Very helpful as supplementary material (in fact most of the time, supplanters) to my lectures in medical school.
A question: in advanced renal failure, where there’s an inability to dilute urine due to increase in osmotic diuresis, how can this lead to hyponatremia?
Several other viewers have asked for this topic in recent months, and it’s on my list of upcoming videos. I wish I could give you an approximate target date, but it’s hard for me to predict. I promise I’ll get to it at some point!
In my humble opinion the hyponatremia etiologies by mechanism is lil confusing, for the ease of remembering them I’d rather classify them by:
1.) Increase in the serum water content
2.) Decrease in the serum sodium content (in actual or relatively to the increment of other serum substances)
For the list of etiologies for the increase in serum water content:
1.) Primary Polydipsia
2.) SIADH
3.) Renal Failure
4.) Endocrinopathy
Whereas the etiology for the decrease in serum sodium content:
1.) Low BP (shock) or any form of trauma that leads to blood loss
2.) GI losses
@Eric’s Medical Lectures Please enlighten me If there’s any correction or let me know if this way of remembering is more practical or relatively easier besides classifying them by the volume status.
Had a challenging pediatric case of patient who received both cisplatin (may cause RSW) and vincristine (may cause SIADH). Sodium went from 130 to 113 in the course of 24 hours. Additionally, the kid had poor PO while receiving chemo so volume status to differentiate was especially challenging. I wonder if the severity of hyponatremia or urine sodium levels can help distinguish? Or can the difference between daily sodium intake and daily urine sodium output (if this could be collected) assist?
Curious if anyone has any thoughts?
correction of hyponatremia by NSS KG * 1.5 i think it will elevate serum NA BY 12 meq / day and not 6 meq
isn.t it sir?
duration of correction during severe symptomativ hyponatremia is it have time limit or until resolution of symptoms?
hi Eric, thank you very much for the great videos! they are very helpfull.
can u please try to explain in deatail why giving 0.9 saline to SIADH can worsen the hyponatremia (if the urine osmolarity is high enough). thanks
sir can you explain how giving isotonic saline like 0.9 NS will worsen hyponatremia in euvolemic conditions like SIADH as its sodium content is almost similar to plasma?
I’ve had hyponatremia every summer since 2016, due to my epilepsy rx. My symptoms cause: confusion, restlessness, loss of appetite, lightheadedness, pressure on head, and fatigue. Last August was the worst. I waited too long and it felt like I had a bunch of weight on my head, I could barely speak, and my legs felt really heavy. I wish I didn’t have to continue to get this because it’s not fun. There’s only so much salt I can eat.
You are awesome. Thanq for your valuable time and amazing information.
Was watching Armando’s videos as a pre-med, as a med-student, and now as a resident. He is gifted at explaining things in a way that helps cement concepts. Brilliant.
the best electrolyte and ABG analysis that i have ever come across. plz introduce more videos in medicine and surgery if possilbe. thanks a ton
Great lecture and thank you for your extensive answer to my previous question on the ABG. I have a question regarding dehydration and the sodium profile. Many sources state that dehydration without fluid intake causes hypernatremia, and if water intake is initiated, hyponatremia ensues. As far as i recall from physiology, the ADH response to hypovolemia (seen with severe dehydration) would override the inhibition caused by a fall in osmolality, which should cause hyponatremia even in the absence of water intake. How would you explain this conundrum? Thanks in advance!
Huge request, Dr. Seheult: could you please do lectures on basics of pharmacology?
Thank you for all your great videos!
Hello, Dr. Strong. I had 2 questions:
1. Can you please give an example for the anticipated duration of therapy of saline equation? How does one know the anticipated rate of correction?
2. Physiologically speaking, why does the saline Na conc. need to be greater than the urine osms for serum Na to increase?
Very useful & easily digested. God bless you Regarding pseudohyponatremia due to hyperglycaemia there is a rough and rapid way to calculate decrease in sodium
For each 100 mg ↑ in blood glucose the corrected serum Na = ↑ 1.3 mEq/L
Very useful and to the point.It’s easily digested. Thanks a lot. Bon travail
Many Thanks for video lecture. I would really appreciate if you could kindly post the video related with NIV, BiPAP, CPAP and the mechanism involved in these modalities.
Distinguishing SIADH vs. CSW via urina Na: I’m not familiar with a difference in urine Na levels and a brief lit. review I just did failed to turn up mention of this either. Not to say there definitely isn’t one, but it seems, at the very least, not well described. Though there are a couple of theories, the definitive pathophys of CSW is unknown. Furosemide is a well known cause of hyponatremia (though anecdotally, not as much so as thiazides), though it shouldn’t cause hypernatremia.
Thank you kind sir. This is great to review for teaching my residents/ med studs during rounds!
I was cured of this by eating laxative chocolate, is that unusual?
Thank you. It is very helpful for reviewing. I ask you a little bit slow talking. You know English is not everyone’s native language
That’s the best series of lectures I’ve ever seen! That’s awsome
…Second, you’re absolutely right that the oral salt will likely all be excreted. However, since sodium excretion requires water excretion, as long as the amount of increased oral water that might accompany the salt tabs is less than the min amount of water necessary to excrete the oral salt load (i.e. more water is lost than gained), the serum sodium should improve.
I had similar teaching as you when in med school, and was initially confused in residency when I saw attendings prescribing salt tabs for SIADH. 2 key principles: First, you are correct that salt tabs + water = IV saline, which is why it’s important to always combine salt tabs with fluid restriction. Salt tabs + unlimited water risks making SIADH worse, just like saline…
As always, the video is very helpful and easy to understand. I have a question though, I was classically thought that the disorders of sodium reflect the disorders of water and so is the treatment. Can you please explain the role of sodium tablets in treatment since it appears to me that no matter how much sodium you give PO it will be excreted and not affect the serum level.I reviewed this on uptodate and it seems salt tablets plus oral water intake is equivalent to giving normal saline IV.
I think a few things need to be corrected for example, in hypervolemic hypotonic hyponatremia, RAAS plays a big role(not pointed out). Another is that Thyroid hormone is required to suppress ADH, and is a cause of isovolemic hypotonic hyponatremia. I recommend to revise this video. A third is CKD causes isovolemic hypotonic hyponatremia; in those conditions you are not able to produce dilute urine and therefore lose salt
I am a great fan of all your videos and lectures by the way. Keep up the great work!!!
This has already been put in practice by the EdX courses. By the way, have you thought on creating a course on one of such platforms? EdX is great!
…Hopefully, someday YouTube will create a feature in which videos can be played back at different speeds. For example, one viewer could play the video at 90% full speed to help understand what might be a different language from his/her primary one, while another viewer could play the video at 110% full speed in order to view videos more quickly, and watch more of them per unit time. That would solve this problem, though I suspect there are significant technical limitations to this.
All these videos explaining hyponatremia and SIADH for trainee medicos and other health professionals.
Great. But what about the patient??? How does the patient find out what to do on a new diagnosis??? When I exercise in a warm climate do I just not drink. and become dehydrated. Or do I drink and take a salt tablet?
Do I just give up on a healthy exercise regime???
Where’s the information for the layperson and patient???
THANK you very much it is great job but i need to ask that i had read that we can differentiate SIADH and cerebral salt wasting by measuring urinary sodium,yes i know both will be high but more higher in cerebral salt wasting, the other issue what is the pathophysiology of cerebral salt wasting, and lastly frusemide diuretic mention as a cause of hyper and hypo natrimea due you agree about that.
Hi iv had a couple of discussions with friends who say that hypervolemia means an increase in intravascular fluid compartment ONLY hence the ending -emia (to do with blood).
If this is true then why do we call cases of CHF, nephrotic syndrome and cirrhosis Hypervolemic?
My answer is that Hypervolemia can be defined as an increase in total body water compartment, and not necessarily intravascular (though this is the most common use of the term). What is the correct answer please? Does anyone out there know?
How can it be cured??? Please advise
My aunt is going through hyponatremia.. She is hospital… It seems like it got cured and under control but again severe symptoms of hyponatremia are showing… There is no permanent treatment and cure for this desease?!!
Please advice
Thank you Dr Strong, this is an excellent lecture, one need to know to take care hyponatrimia, so thorough.
Very clear video, great job! Thanks for creating these series!
One thing I’d like to bring to your attention: from your video it might be incorrectly assumed that intracellular and extracellular sodium concentrations are equal, which they are not (12 mmol/L vs 140 mmol/L respectively).
I went to the doctor and when I got there, I got out of my car and my legs got so weak I was shaking and could barely walk. I had to have help into the doctors office. I had a headache that wouldn’t go away. They did blood work and my sodium was very low. I was told to go home and eat alot of salt. Nothing is working. I’m losing my balance and scared I’m going to fall. My legs and feet cramp like crazy. When my legs get weak, I go down and it’s like I have no control of my legs at all. I’m scared and don’t know what to do
cerebral pontine myelinosis!!! not cerebral edema
Thank you Great Video
Your explanation makes complete sense, thank you so much. I would love to round with you I think that would be a great experience:)
I drank 1.25 litres of water in the space of 30 seconds and woke up a few hours later and started vomiting. I have the worst stomach pain I’ve ever experienced, and can’t sleep. Do I have this condition and will I die ����. I am actually so worried someone pls tell me if that amount of water is enough to kill me
hi i was just wondering if you have any links to the references that you have used? i would like to use this for my assignment but i need to include review papers too!
(hopefully you see this in time)
When you add normal saline at 15:16, the read line is supposed to stay at the vertical level of the purple line right? Because the Na+ concentration doesn’t change, right?
Thanks! Could you make more use of different colors in the next videos? It helps with getting the message across more clearly.
Wouldn’t taking diuretics make you lose more sodium with the water and make the problem worse?
I drank 2 16.9 oz of water within 1 hour and by the time i have posted it has been about 13 hours. I am 15 and I’m afraid I might die, I haven’t told my parents because my mom has warned me before. I was not doing any exercise within that time and I want to know what the possibility of me dying rn is. Please help
Thank you. Your explanations make it all of it clear and easy to remember.
It´s not the same 135 mEq/l and 135 mg/dl. Because 1 mEq/L = 2.3 mg/dl
It’s really good to finally understand the basic things here. Thanks
I really appreciate the way you teach. You made my work way easier. Thank You
is dat if medicine for hypothyroid is stopped for few days may cause hyponatremia
See the whole series at http://www.medcram.com along with other top quality videos including reviews in pulmonary, cardiology, infectious disease, and hematology!
Unbelievable that after two years of nursing school, I don’t think I ever COMPLETELY understood WHY 0.9% NS was what you used. Thanks so much!
The foundation or basics count in any construction or knowledge building. Great explanation!
thanks dr for the amazing series! i have a presentation on hyponatremia and ur lectures are the best reference!
i hv a suggestion: could u plz do lectures on antiarrythmics and explain the physiology underlying them.. this is a vry tough topic fr me and i would appreciate that so much.. thx:)
Also, thank you again for the invaluable contribution you’re making to online medical education through these various videos.
from stewart approach of acid base, i think normal saline isnt the best balanced solution for resuscitation
Wow, It’s amazing to learn from teachers who teach with passion. Thanks. “if you can’t explain it simply you don’t understand it well enough”, you’ve made ir pretty simple. <3
this happened to me a few days ago.. it was absolutely hands down the worst experience in my life. i thought i might die or else i would end up permanently brain damaged. i think i was VERY close to having a full on seizure and becoming unresponsive.. luckily i got an iv with sodium drip and it managed to fix it (albeit after many more hours of pain). they were giving me valium and morphine and it barely touched the pain i was feeling. i couldn’t hold still. my limbs were just jerking all over the place. even the valium didn’t really stop it.. just slowed my twitching down a little
what is the reason of hyponatremia in pneumonia? what is the relation of pneumonia with hyponatremia?
We can measured osmolality using instrument..such as Advance Osmometer 3320…Will that be different??
Hyponatremia and fluids are one of the hardest concepts to grasp-at least in my view-and thankfully you have clearly explained this concept in a way I visualize it and understand it! Thank you SO much! I’m a pharmacy student on a critical care rotation in a burn unit and was told to look up how to to workup/assess and treat hyponatremia and after watching & taking notes on these videos I feel absolutely confident to explain this concept!
OMG I LOVE YOU DR.SEHEULT! thank you so much for this clear explanation!!!!
I can’t believe there are people who don’t like this video. Thank You. This is awesome!
Thank you so much! I told some friends about Med Cram and appreciate your help. I would love to see more topics in the future.
I also appreciated your videos on Hypoxemia/Hypoxia.
You should work for Kaplan or come out with your own series covering all subjects from Pharm to Path to Microbiology and so on.
Thanks so much; you do an excellent job on these. I’d love to see you handle all the electrolyte disorders commonly found on Step 2, etc. as well as renal tubular acidoses. Great work!
this might have been mentioned before, but you said 0.9% saline, but.09% was written at 14:30.
Also thanks many times for this lecture series easily one of the best on youtube!
For all the med students here: know that consumption of mdma can lead to Hyponatremia. So if you have a patient coming from a nightclub, don‘t forget that it could be Hyponatremia and you may save a life.
Saw all four videos for topic, I have a better understanding. Awesome job!!!
Hi doc.. Very good video on a very difficult and interesting topic. I have a question… You mentioned that hyponatremia due to elevated ADH can be caused by volume depletion. Won’t aldosterone and angiotensin II resolve the hyponatremia by increasing renal sodium (and also water) reabsorption? Or is it because the release of ADH which only reabsorbs water that produces the net effect of increase in solute-free water reabsorption, rather that sodium-rich water reabsorption, that causes the hyponatremia? Many thanks:-)
Glad to clear things up completely. Thanks for the feedback.
I was looking many years for this lecture. Comprehensive and easy to remember. Thank you.
Glad you found the series useful. We’ll put Hypernatremia on the slate for a future lecture. We are doing a vote on our MedCram Facebook page for the next topic to be covered. Take a look if you get a chance.
I’ve read so many books and attended so many talks but never like this. Many thanks Roger,you have no idea how many people you have had helped. I’m still waiting for hypernatremia.
…There’s a surprisingly small amount in the literature about the use of oral salt tablets for long-term management of SIADH (even compared to the conceptually similar treatment option of oral urea). I’ve seen salt tabs used a number of times with apparent effect, though I appreciate that my personal case series of a dozen patients doesn’t substitute for a large RCT. However, physiologic principles do seem to support the approach as well. Hope that helps!
i searched videos for hypernatremia but i didnt find,,,can you help me please?
thanks alot for this incredible teaching videos,,,its the best
again thanks
I’m probably one of the most stingy person to give “Like”. This definitely deserves one. Great lecture.
Thank you for catching this mistake. An annotation at 2:37 has been added to correct it.
Did you erase your video with the pictures and all the electrolytes in a short video? These videos don’t help cram last minute like the other one did. I’m sad I can’t find it
Please correct the units of sodium in 135 mg/dL to 135 mmol/L or meq/L from 1:35 onwards. That is the unit that the Clinical Chemistry laboratory provides you with.
No, because you are only measuring the nitrogen attached to the urea (and not the exogenous nitrogen).
BUN: Blood Urea Nitrogen. It is a measure of the amount of nitrogen in the blood in the form of urea, and a measurement of renal function