Category: Nephrology

  • The Painless Guide to Mastering Clinical Acid-Base (2017)

    The Painless Guide to Mastering Clinical Acid-Base (2017)

    The Painless Guide to Mastering Clinical Acid-Base (2017) is a 180-page introductory acid-base biochemistry book. The book is very clear and well written and hits on all the major aspects of acid base disorders in the context of their underlying biochemistry and pathophysiology. For example, the biochemistry of ketoacidosis is discussed in fine, precise and…

  • Medical Question: Flank Pain

    Medical Question: Flank Pain

    A 60-year-old female presents to the emergency department complaining of intense left sided-flank pain radiating to the groin. Urinalysis is positive for gross hematuria, while a non-contrast CT of the abdomen and pelvis is negative for stones. The patient is sent for a contrast CT of the abdomen and pelvic, from which the following image is…

  • Hypocomplementemia: Key Points and Mnemonics

    You don’t need to memorize which glomerulonephritides are associate with low complement and which are not. Rather, ask yourself one question: does this patient have persistent, aggressive, endovascular, systemic infectious or inflammatory processes? If the answer is “yes,” then the disease is associate with low complement levels. If the answer is “no,” then complement level…

  • How to Solve Triple Acid-Base Problems Quickly in Your Head

    How to Solve Triple Acid-Base Problems Quickly in Your Head

    Introduction You can solve triple acid-base problems with basic arithmetic and straightforward logic. As an example, let’s work through the following rather classic triple acid-base problem: An afebrile, atraumatic 26-year-old male with no past medical history is brought to the emergency department because of a three hour history of altered mental status, vomiting and vertigo. The physical examination is…

  • How to Spot a Falsely Normal Anion Gap

    Introduction A high anion gap metabolic acidosis can be a very dangerous acid-base abnormality. The “gap” itself is just a number – it isn’t harmful per se. Rather, the danger is from the acidosis and from the process that is generating the abnormal and excessive organic acid load. The most common screening test for high anion gap…

  • Hypermineralocorticoidism Explained

    Introduction Aldosterone is the most important mineralocorticoid in the human body, although various other hormones, such as cortisol, display mineralocorticoid activity as well, namely they cause hypertension, hypokalemia, and chloride resistant metabolic alkalosis (urine chloride > 20). In addition, mineralocorticoids can also cause hypernatremia and hypervolemia. The triad of hypertension, and hypokalemia and chloride resistant metabolic alkalosis should…

  • Acid-Base Abnormalities and Their Causes

    Introduction Acid-Base pathophysiology plays an important role in every aspect of medical practice, including psychiatry. Doctors and medical students need to know, both for real life and for examinations, the predicted acid base disorder of various diseases. It is much easier to interpret ABGs when you know ahead of time what to expect: So let’s start…