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diagnosis differential nephrology algorithm metabolic causes management aspirin drug false gitelman hypokalemia positive salicylate toxicity uds workup alkaliintake barttersyndrome bicarbonate
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm Volume Depleted 2° hyperaldosteronism • Low Urine Cl-: Vomiting, NGT
Primary Metabolic Alkalosis ... hyperaldosteronism • Low Urine ... (late) • High Urine ... , Gitelman Syndrome ... Primary #Metabolic #Alkalosis
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm Volume Depleted - 2° hyperaldosteronism • Low Urine Cl-: Vomiting,
Primary Metabolic Alkalosis ... hyperaldosteronism • Low Urine ... (late) • High Urine ... , Gitelman Syndrome ... aldosteronism #Metabolic #Alkalosis
Causes of Metabolic Alkalosis - Differential Diagnosis Algorithm Urine chloride < 20 mmol/l - Chloride responsive (Chloride
Causes of Metabolic Alkalosis ... Diagnosis Algorithm Urine ... diuretic use Urine ... BP = Bartter's Syndrome ... , Gitelman's Syndrome
Metabolic Alkalosis - Urinary Chloride Algorithm Cl- responsive metabolic alkalosis • Kidney loss of Cl-
Metabolic Alkalosis ... responsive metabolic alkalosis ... diuretic use, Bartter syndrome ... , Gitelman syndrome ... Urine chloride is
Approach to Elevated Bicarbonate (HCO3) Risk Factors for Hypercapnea? (Hx of COPD, OSA, sedative use, CNS/muscular disorders?) (+)
Likely Metabolic Alkalosis ... Urine CI < 20 ... Volume Contraction Urine ... Barter, or Gitelman Syndrome ... Elevated #metabolic #alkalosis
Causes of Metabolic Alkalosis: Differential Diagnosis ECF volume contracted: urine chloride concentration <20 meq/L • Gastric alkalosis:
Causes of Metabolic Alkalosis ... volume contracted: urine ... /L • Gastric alkalosis ... volume expanded: urine ... contracted: but urine
Hypokalemia Evaluation Algorithm Before evaluating hypokalemia, life threatening complications such as arrhythmias and paralysis should be looked
A urine K/Cr ratio ... • Diarrhea A urine ... ↓ Aldosterone: Syndrome ... - Metabolic Alkalosis ... , Gitelman syndrome
Workup for Hypophosphatemia - Differential Diagnosis Framework Rule out spurious hypophosphatemia: paraproteinemia, acute leukemia Measure Urine Fractional Excretion
leukemia Measure Urine ... Glucose, Acute resp. alkalosis ... , Hungry bone syndrome ... Tumor genesis syndrome ... FGF-23: Fanconi syndrome
False Positive Urine Drug Screens Amphetamines - Amantadine, brompheniramine. bupropion, chlorpromazine, desipramine, ephedrine, isometheptene, isoxsuprine, labetalol, phentermine,
False Positive Urine ... fluoroquinolones, poppy ... Positive #UDS #Urine ... Screening #diagnosis #toxicology
Salicylate Toxicity - Diagnosis and Management Consider if: 1) Patient is hot and altered 2) You see tachypnea with
Acidosis, Respiratory Alkalosis ... Resuscitation 2) Urine ... Aspirin #Toxicity #Toxicology
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