Interventional nephrology is quickly becoming a sought after “subspecialty” of nephrology. However, many training programs do not offer a structured training program (as highlighted in this recent AJKD paper). Traditionally nephrology training is spent rounding in the hospital,…
The whole fiasco about the antenna and reception issue with the iPhone 4 made me realize that unlike other professions, where several chances exist to rectify a problem, clinicians often have only one chance to get it right…
This was an actual case I saw and thought it generated a multitude of interesting dilemmas. When I initially examined the patient she was in status epilepticus. This, by itself, mandated the immediate correction of her serum sodium….
A 40-year-old woman is rushed to ER for change in mental status. She has a history of multiple sclerosis and alcohol abuse. On arrival to ER, she exhibits 3 stereotyped, tonic-clonic seizure that resolve with ativan. The initial…
Not long ago while on call I received a midnight consult for hyperkalemia. The patient had a history notable for CLL, who was electively admitted to for induction chemotherapy. Prior to this admission, he had received no previous…
An interesting article was published in the August 4th edition of Cell Metabolism. I’m always intrigued when common food ingredients are used to modulate biological systems. This article explores the effect of capsaicin on blood vessel tone. Capsaicin…
Much of medical residency training in the US is centered in the hospital. This is also true of many of the fellowship programs in internal medicine. As we have seen a continual increase in the number and acuity…
Each of the following choices is expected to occur during pregnancy except for A and D. Let’s go through each of the possible choices. A. This in partially incorrect. Hyperventilation (with resultant hypocapnea, not hypercapnea) occurs during pregnancy…
Hypokalemia and metabolic alkalosis are considered precipitating factors for hepatic encephalopathy, as hypokalemia stimulates ammoniagenesis in the proximal tubule. Although, the mechanism is not entirely clear, the likely hypothesis is as follows: *Hypokalemia causes the movement of potassium…
Hepatorenal syndrome (HRS) is a frequent consult encountered on the nephrology service. The criteria have recently been revised. Conall reviewed the revised criteria on a prior post last year. To review the pathophysiology of HRS click here. In…
