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Viresh Mohanlal

The Diet Pill and the Deadly Acidosis

I was recently called to evaluate an obese patient with profound metabolic acidosis who was admitted to the hospital with change in mental status and poor oral intake for several days. Her admission labs revealed severe hyperglycemia (glucose…

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An eye opener!

Call it serendipity or mere coincidence, I recently saw a patient with Prostate cancer treated with an experimental chemotherapy protocol that was sent to our clinic for evaluation of Fanconi syndrome and proteinuric stage 3 chronic kidney disease…

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Appropriate or inappropriate: stop guessing

In the evaluation of patients with hyponatremia (serum Na less than 135 mEq/L), differentiating hypovolemia from euvolemia is often challenging, particularly if the history and physical findings are unrevealing and frequently leads to misdiagnosis. This conundrum exists even…

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Something fishy?

A 30-year-old man was admitted to our hospital for evaluation of lung nodules detected during pre transplant evaluation for his stage V chronic kidney disease (CKD). Sounds routine, but what caught me completely clueless was when I was…

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Get it right …the first time

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…

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Cisplatin induced hyponatremia; looking deeper

Cisplatin based therapy for the treatment of solid organ tumors is commonly associated with several renal abnormalities including; *hypokalemia*hypomagnesemia*hypocalcemia*hypophosphatemia*fanconi-like syndrome*acute kidney injury We have all seen these complications on the renal consult service at least once. However, less…

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