Renal/Electrolytes

A Woman with Arm Spasms

Anita Mudan, MD^* and Wilma Chan, MD, EdM^*

DOI: https://doi.org/10.21980/J8VP88Issue 4:2 No ratings yet.

The patient had a witnessed episode of isolated left upper extremity jerking, shown in the video, during which she was completely awake and conversant. Lab results were significant for serum glucose of 1167 mg/dL, no anion gap, and negative serum/urine ketones. She had a computed tomography (CT) of the head that did not show any acute pathology, and underwent a brain magnetic resonance imaging (MRI) without any signs of stroke or other pathology, shown below.

Computed Tomography and Ultrasound Diagnosis of Spontaneous Subcapsular Renal Hematoma

Samer Assaf, MD^*, Thalia Nguyen^* and Alisa Wray, MD^*

DOI: https://doi.org/10.21980/J8062DIssue 3:1 No ratings yet.

Bedside ultrasound was performed and demonstrated a hypoechoic area within the left kidney (images not shown). The non-contrast computed tomography (CT) of the abdomen and pelvis shows a significantly enlarged left kidney and a region of high-attenuation encapsulating the left kidney, concerning for acute hemorrhage.

Renal/Electrolytes Visual EM

Acute Pyelonephritis with Perinephric Stranding on CT

Ronald Goubert^* and Jonathan Peña, MD^*

DOI: https://doi.org/10.21980/J8BH0VIssue 3:1 No ratings yet.

A CT abdomen and pelvis with IV contrast showed neither nephrolithiasis nor diverticulitis, and instead showed heterogeneous enhancement of the left kidney with mild edematous enlargement and striated left nephrogram. Significant perinephric stranding (red arrows) was also noted and was consistent with severe acute pyelonephritis.

Renal/Electrolytes Infectious Disease Visual EM

Hemodialysis in the Poisoned Patient

Megan Boysen-Osborn, MD, MHPE^* and Jeffrey R Suchard, MD, FACMT^*

DOI: https://doi.org/10.21980/J88S68 Issue 2:4 No ratings yet.

By the end of this cTBL, the learner will: 1) recognize laboratory abnormalities related to toxic alcohol ingestion; 2) calculate an anion gap and osmolal gap; 3) know the characteristics of drugs that are good candidates for HD; 4) discuss the management of patients with toxic alcohol ingestions; 5) discuss the management of patients with salicylate overdose; 6) know the indications for HD in patients with overdoses of antiepileptic drugs; 7) discuss the management of patients with lithium toxicity.

Team Based Learning (TBL)Renal/Electrolytes Toxicology

Renal Infarction from Type B Aortic Dissection

Marit Tweet, MD^* and James Roy Waymack, MD^*

DOI: https://doi.org/10.21980/J8HG9G Issue 2:3 No ratings yet.

Initial abdominal images demonstrated a dissection flap; therefore, a CTA of the chest was also obtained. These images revealed a Stanford type B aortic dissection beginning just distal to the left subclavian artery and extending to the origin of the inferior mesenteric artery. The right renal artery arose from the true lumen of the dissection while the left renal artery arose from the false lumen. This case is interesting as imaging shows the lack of perfusion to the left kidney, residing in the retroperitoneum, which correlates with her non-descript abdominal and left flank pain.

Cardiology/Vascular Renal/Electrolytes Visual EM

Ectopic Kidney

John Costumbrado, MD, MPH^*, Reid Honda, MD^{^} and Eric McCoy, MD, MPH^{^}

DOI: https://doi.org/10.21980/J89058 Issue 2:3 No ratings yet.

CT of the abdomen and pelvis revealed a normal left kidney and an ectopic, malrotated right kidney located in the pelvis (see white arrow).

Renal/Electrolytes Visual EM

Emergencies in Hemodialysis Patients

Shannon Toohey, MD^*

DOI: https://doi.org/10.21980/J81591Issue 1:1 No ratings yet.

By the end of this session, the learner will: 1) describe primary dialysis complications; 2) construct a full differential for a dialysis patient presenting with complications; 3) formulate an appropriate treatment and resuscitation in an acutely ill dialysis patient; 4) plan appropriate disposition and utilization of consultants for dialysis complications.

Renal/Electrolytes Team Based Learning (TBL)