“Unresponsive” continued

High-Anion Gap Metabolic Acidosis (“HAGMA”) Note how the labs were significant for an acidemia (pH < 7.35) with an anion gap of 21. Respiratory compensation is appropriate, as calculated using Winter’s Formula Differential diagnosis includes ketonemia, uremia, lactic acidemia, or ingestion of substances such as ethylene glycol, propylene glycol, methanol, salicylates, tylenol, or toluene AlsoContinue reading ““Unresponsive” continued”

Secondary Hypertension

~10% of cases of hypertension are secondary to another disease process (1). Secondary hypertension should be evaluated in young patients with otherwise-unexplained hypertension or patients with difficult-to-control hypertension. The most common etiologies are: Hyperthyroidism Hyperaldosteronism Hypercalcemia Obstructive Sleep Apnea Renovascular Hypertension Chronic Kidney Disease Coarctation of the Aorta Cushing Syndrome PheoChromocytoma One mnemonic to rememberContinue reading “Secondary Hypertension”

“Blood in My Urine” continued

Nephrolithiasis Urology consulted, performed ureteroscopic stone fragmentation and removal the following day Hypercalcemia Treated with IV fluids, Zoledronic Acid, and Calcitonin -> serum calcium normlized within 2 days Hydrochlorothiazide was discontinued PTH resulted low at 8 pg/mL 25-OH-Vitamin D and 1,25-OH-Vitamin D levels were within normal limits PTHrP ordered, returned a few days later elevatedContinue reading ““Blood in My Urine” continued”