- Burns
- Capillary leak due to sepsis
- Diabetes Mellitus
- Hyperaldosteronism
Correct Answer : Hyperaldosteronism
Ref: Harrisons 17th edition page 1445, 277
In Hypervolemic hyponatremia like CCF, Nephrotic syndrome and Cirrhosis there is decreased effective intravascular volume leading to activation of the Renin – Angiotensin system. This leads to hyperaldosteronism and further water retention. There is primary sodium gain due to hyperaldosteronism but this increase is exceeded by the amount of secondary water gain – resulting in increased dilution of sodium in water – hyponatremia
In Burns and Capillary leak due to sepsis – the patients are hypovolemic not hypervolemic
In Diabetes Mellitus – Hyponatremia is due to increased plasma osmolality ( because of high glucose
level) – Pseudohyponatremia. For every 100mg/dl increase in glucose level the sodium level will decrease by 1.6mmol/L
In Hypervolemic hyponatremia like CCF, Nephrotic syndrome and Cirrhosis there is decreased effective intravascular volume leading to activation of the Renin – Angiotensin system. This leads to hyperaldosteronism and further water retention. There is primary sodium gain due to hyperaldosteronism but this increase is exceeded by the amount of secondary water gain – resulting in increased dilution of sodium in water – hyponatremia
In Burns and Capillary leak due to sepsis – the patients are hypovolemic not hypervolemic
In Diabetes Mellitus – Hyponatremia is due to increased plasma osmolality ( because of high glucose
level) – Pseudohyponatremia. For every 100mg/dl increase in glucose level the sodium level will decrease by 1.6mmol/L
| |||||||||||||||||||||||||
|