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Question of the Day

A 55 y/o M with h/o of CKD 4 due to diabetic nephropathy has been on tri-weekly EPO for the last 6 weeks for anemia of CKD is found to still have a hemoglobin of 9.2.  He denies any obvious bleeding but reports being hospitalized twice in the last 3 months for diabetic ulcers and…
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Fill Me Up – An Arguement Using More Balanced Solutions

History of NS vs LR In the great fluid infusion debate internist have favored normal saline, while surgeons have preferred lactated ringers. It looks like our surgeon friends may have gotten it right. Normal saline was never actually “invented” to be a volume replacement therapy. Wikipedia reports that it was discovered in 1831 by William…
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Nephrology Practice Board Questions – FSGS

As I’ve been studying I’ve been trying to make up questions of information that I found to be important or interesting (at least to me). These questions and those to follow are a random grouping of  multiple choice, true/false, or guess what I’m thinking. 1.) Collapsing FSGS is associated with what disease/drugs? 2.) Which monosaccharide…
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I'm back!

Sorry for the hiatus but we (I’ve) been in between credentialing, board studying, and work (as well as a new baby that should be here anyday). I’ll try to post board questions on a weekly basis from here on out. Still deciding if I’ll post next year or leave it up to the new fellows.…
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Dialysis vs Bicarbonate Therapy For Lactic Acidosis

In the world of critical care medicine sepsis with subsequent Type A Lactic Acidosis (fig 1.) is a common occurrence. And of course the question of should the patient be dialysis for acidosis (the A in AEIOU for emergent dialysis again) arises. This is a difficult answer and one that should be evaluated on a…
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Differential Diagnosis of AKI in Liver Disease

I recently received a consult for a liver patient with Hep B and Hep C with cirrhosis that developed worsening ascites and oliguric AKI I ask the resident if the usual initial evaluation was done and she was unaware of what that was, therefore I decided to briefly touch on the differential diagnosis and evaluation…
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Differential Diagnosis of the Day (3D) – Nephrotic Syndrome

  Primary Causes FSGS Membranous Membranoproliferative Ig A Minimal Change Disease Secondary Causes Diabetic Nephropathy Lupus Nephropathy Amyloidosis/Light Chain Deposition Disease HIV(membranous, membranoproliferative, FSGS)

Complement and Renal Disease

  Commonly in the work up of nephrotic syndrome we think serum complements are ordered because they help us narrow down our differential diagnosis. Here is a quick reminder of which conditions cause what. As a quick reminder remember that classical activation involves the binding of C1q to the Fc region of IgG and IgM…
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Neph Madness is here!

Time for all renal fellows, residents, interns, students (and lovers of the red beans) to fill out your brackets for nephmadness. Its fun as it’s March and you’ll have your other brackets out. Also you should learn something along the way. Check it out at www.nephmadness.com. Brackets due by March 26.