The Clinical Problem Solvers

Episode 256: RLR – Nausea with a twist

21 snips
Sep 14, 2022
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ANECDOTE

French Visitor with Complex Presentation

  • An elderly woman visiting from France presented with nausea, vomiting, and severe hypertension.
  • The difficulty in clinical reasoning was compounded by language barriers and the patient's confusion.
INSIGHT

Primary Hypertension Limits

  • Primary hypertension alone does not cause acute symptoms or emergencies.
  • Acute or secondary hypertension, or an additional acute cause, must be present to explain such presentations.
ADVICE

Approach Hyponatremia Carefully

  • Assume hyponatremia is hypotonic and involves excess water.
  • Confirm elevated urine osmolality to assess ADH effect before diagnosing causes like SIADH.
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