REBOOT #48 Hyponatremia Deconstructed

Take your salt game to the next-next level. We brushed off this fan favorite episode and rebooted #48 hyponatremia deconstructed with our Chief of Nephrology, Dr. Joel Topf aka @kidney_boy aka The Salt Whisperer for your CME earning pleasure. Learn the correct steps to diagnose and manage this common and dangerous condition. Topics covered include: true versus false hyponatremia, SIADH, tea and toast hyponatremia, beer potomania, safe rates of sodium correction, IV fluid choice, vaptans and more.

Listeners can claim Free CE credit through VCU Health at http://curbsiders.vcuhealth.org/ (CME goes live at 0900 ET on the episode’s release date). 

Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | [e-mail] | Free CME!

 

Credits

• Original episode written and produced by: Matthew Watto MD, FACP 
• Show Notes and CME questions by: Deb Gorth ScM
• Cover Art and Infographic by: Edison Jyang
• Hosts: Stuart Brigham MD; Matthew Watto MD, FACP; Paul Williams MD, FACP   
• Editor: Molly Heublein (written materials); Matthew Watto MD (audio) 
• Guest: Joel Topf MD

Sponsors

 

POCUS Fellowship at University of Pennsylvania

A novel, collaborative, POCUS fellowship training is available at the University of Pennsylvania for IM and FM graduates!  In 2016 they leveraged the robust EM ultrasound fellowship training infrastructure with UPenn’s progressive Department of Medicine to create the 1st multi-specialty clinical ultrasound fellowship.  Their graduating fellows have made them proud by accepting leadership positions, and if you want to be on the cutting edge, you should join their team.  

Interview season is in full swing and they’re actively accepting applications.  Please go to pennultrasound.org or contact [e-mail] for information.  You can apply for fellowship using the eusfellowships.com portal.

 

VCU Health CE

The Curbsiders are partnering with VCU Health Continuing Education to offer FREE continuing education credits for physicians and other healthcare professionals. Visit curbsiders.vcuhealth.org and search for this episode to claim credit. Note: A free VCU Health CloudCME account is required in order to seek credit.

 

Time Stamps

• 00:00 Intro
• 03:30 Guest interview
• 07:15 Pick of the week w/Dr. Topf
• 16:20 Clinical case of hyponatremia
• 17:48 False hyponatremia normal osmolality
• 19:34 False hyponatremia high osmolality
• 20:36 Understanding why osmolality matters
• 23:28 Workup false hyponatremia
• 24:45 Recap of discussion so far
• 25:40 ADH dependent vs independent hyponatremia
• 27:00 Psychogenic polydipsia
• 289:15 Renal failure and hyponatremia
• 30:03 Tea and toast, and Beer Drinker’s potomania
• 35:22 ADH dependent hyponatremia
• 38:15 Volume versus osmolality
• 40:00 Volume status exam
• 45:14 Additional testing with urine lytes and uric acid
• 47:30 Treatment for SIADH 
• 52:42 Discussion of the vaptans
• 58:21 Additional testing in SIADH
• 62:50 When to admit patient for hyponatremia
• 63:59 Clinical case of hyponatremia complications
• 68:56 Fluids and rate of correction
• 73:36 DDAVP clamp
• 76:30 Moderate hyponatremia
• 78:35 Diuretic dosing DOES matter!
• 81:59 Loop diuretics for SIADH
• 84:25 Take home points
• 87:25 Outro

Links*

1. Dr. Joel Topf’s Textbook
2. Dr. Joel Topf’s Blog
3. Dungeons and Dragons
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