The Protege Effect

The best way to learn something is to try to teach it to others. The sense of responsibility to your student motivates you to understand a topic, and the act of explaining something helps you to connect the dots and commit them to memory.

4.30.25

1. **Normal Serum Osmolality Range**: 275 to 295 milliosmoles per kilogram.

2. **Normal Urine Specific Gravity**: 1.010.
3. **Medications that May Mask Hypoglycemia Signs**: Beta blockers, specifically metoprolol, may mask signs like shakiness, increased heart rate, and irritability.
4. **ADH Function**: Antidiuretic hormone (ADH) is involved in maintaining fluid balance. It responds to hypotension, hypovolemia, hypernatremia, and dehydration.
5. **Signs of SIADH**: Decreased urine output, decreased serum osmolality, and hyponatremia.
6. **Signs of Diabetes Insipidus (DI)**: Increased serum osmolality, increased serum sodium, and decreased urine osmolality.
7. **Thyroid Function Tests**: T3 and T4 will be increased in hyperthyroidism along with decreased TSH.
8. **Myxedema Coma**: The most severe form of hypothyroidism, characterized by altered mental status, hypothermia, bradycardia, and need for IV levothyroxine.
9. **DKA vs. HHS**: Understand the differences in serum osmolality and the need for fluid resuscitation.
10. **Complications of SIADH**: Severe hyponatremia can lead to seizures.