John Reneau retweetledi
John Reneau
908 posts
John Reneau
@LymphomaMD
#Lymphoma #LymSM specialist at @OSUWexMed @OSUCCC_James. Tweet ≠ medical advice.
Columbus, OH Katılım Haziran 2018
302 Takip Edilen889 Takipçiler
Spoiler. It's actually Evusheld. Will definitely need to have some in depth discussions about benefits with any patients who ask for it...
John Reneau@LymphomaMD
How much would you pay for exorbitantamab?
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@OhioStateIMRes I'm back on Twitter for a bit to get some intel for tomorrow's lecture on aggressive lymphomas - let me know what you want to learn about!
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Covering for a friend this weekend, his inbox is anxiety provoking 😬
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I have just discovered Hematologist Twitter and I am happy/horrified to report that it is nerdier than Con Law Academic Twitter
John Reneau@LymphomaMD
#askrenal elderly lady admitted with Na 120 (135 3 days ago). Chronically poor po intake with nausea/vomiting, diarrhea 4 times daily. Sosm 243, Uosm 397, spec grav 1.013, UNa 45, SCr 0.72. Seems like straightforward hypovolemic hyponatremia, but why high UNa? No diuretics...
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#askrenal elderly lady admitted with Na 120 (135 3 days ago). Chronically poor po intake with nausea/vomiting, diarrhea 4 times daily. Sosm 243, Uosm 397, spec grav 1.013, UNa 45, SCr 0.72. Seems like straightforward hypovolemic hyponatremia, but why high UNa? No diuretics...
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@GharibSary Seems like more of the latter today... N some response but minimal (124), uosm remains high. TSH and cortisol normal. Looking more like SIADH
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@LymphomaMD You may try first normal saline infusion and if fup serum sodium increased, it is Hypovolemic hyponatremia. If hyponatremia worsened, it is euvolemic ( hypothyroidism, hypocortisolism, SIADH )
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@LymphomaMD Does the patient has metabolic alkalosis to explain high urinary sodium?
Low s.uric acid make euvolemic hyponatremia more likely.
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@LymphomaMD Are they alkalotic? Urine bicarbonate requires obligate sodium excretion cause, you know, charges.....
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@LymphomaMD low urine output as a result of hypovolemia can cause the urine [Na] to appear elevated.
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@LymphomaMD Serum uric acid can also be helpful here (increased serum uric acid is suggestive of hypovolemic hyponatremia).
Check out Table 3 here for hyponatremia + increased UNa causes: ncbi.nlm.nih.gov/pmc/articles/P….
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