What lab tests are done for hyponatremia?
There are three essential laboratory tests in the evaluation of patients with hyponatremia that, together with the history and the physical examination, help to establish the primary underlying etiologic mechanism: urine osmolality, serum osmolality, and urinary sodium concentration.
How is hypervolemic hyponatremia diagnosed?
A trial of volume expansion with isotonic saline can be used to diagnose hypovolemic hyponatremia. Although a rise in SNa in response to isotonic saline would be consistent with hypovolemic hyponatremia, another possibility would be that the stimulus for vasopressin release in a patient with SIAD abated.
What should I order for hyponatremia?
SORT: KEY RECOMMENDATIONS FOR PRACTICE In patients with severe symptomatic hyponatremia, the rate of sodium correction should be 6 to 12 mEq per L in the first 24 hours and 18 mEq per L or less in 48 hours. A bolus of 100 to 150 mL of hypertonic 3% saline can be given to correct severe hyponatremia.
When does premature adrenarche occur in a girl?
The descriptive term “pubarche” indicates the appearance of pubic hair, which may be accompanied by axillary hair. This process is considered premature if it occurs before age 8 yr in girls and 9 yr in boys. The chief hormonal products of adrenarche are DHEA and DHEAS.
How is puberty an approach to diagnosis and management?
Disorders of Puberty: An Approach to Diagnosis and Management. Puberty is a developmental stage characterized by physical and psychosocial maturation. Abnormal pubertal timing can adversely affect a child’s physical and psychosocial well-being and may be caused by a range of generally benign or pathologic etiologies.
How does abnormal pubertal timing affect a child?
Abnormal pubertal timing can adversely affect a child’s physical and psychosocial well-being and may be caused by a range of generally benign or pathologic etiologies. Physicians must identify which findings are suitable for surveillance over time and which suggest treatable underlying pathology.
When does pulsatile secretion of GnRH occur?
From a physiologic standpoint, this results when pulsatile secretion of GnRH begins and the hypothalamo-pituitary-gonadal axis is activated. Criteria for defining the stages of puberty, proposed by Marshall and Tanner in 1969 and 1970, remain the standard of practice.