This case taken from Book .. A 74 year old female patient .k/c/o Hypertension for the past 2 years C/O Altered behavior and irrelevant talking She is on HCTZ 12.5 O/E CNS - no focal neurological deficit CVS S1 S2 heard Chest clear CT head - normal S Na 118 S K 4.2 What is diagnosis and how would manage the patient ??




Hyponatremia , ? Due to prolonged use of hydrochloric thiazide . Inter current illness which reduce solid intake, increase fluid intake , hypothyroidism, infections can precipitate hypo natremia. Admission ,fluid restriction, increase salt intake to 10 gms/ day, soda mint tablets .IV hypertonic saline, tolvaptin

Might be case of Hyponaturima as information given Correct sodium level See for ecg and normal blood test See for sr calcium and sr vit d3 See ammonia also to rule out metabolic cause See urine routine also

Avoid fluid overload and water restriction

Hyponatremia presenting with altered behavioural disorder Just correct the imbalance Find the cause of hyponatremia R/o hypertensive renal damage

Thanx dr Ramesh Kumar Singh

Symptoms are due to Hypoprotinemea , Serum Sodium level of pt is to be Maintained normal

It happens due to Low sodium Maintain it .

Hyponaturima Current sodium levels and symptomatic treat and lipid profile and Ecg routine urine analysis rft d3 and Vit b12 need

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