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differential hyponatremia hyperkalemia hypokalemia potassium alkalosis hematuria intercellularshift metabolic nongap sodium urology blood chloride ddxof diarrhea epilepticus glomerulonephritis hypochloremia hypomagnesemia
Hematuria Workup and Diagnosis Algorithm • Confirm hematuria → Urinalysis >3 RBCs/HPF, exclude mimics, repeat testing
Algorithm • Confirm ... → Refer to Nephrology ... for renal biopsy ... cystoscopy • Refer to Nephrology ... by UW IM Residency
Algorithm and Differential Diagnosis of Macroscopic Hematuria Important Historical Elements: - Painless: suggests malignancy - Painful: suggests calculi/infection - Urinalysis:
Algorithm and Differential ... Diagnosis of Macroscopic ... RBC’s, RBC/WBC casts ... suggest intrinsic renal ... #EM #IM #Urology
Hypokalemia - Differential Diagnosis Algorithm Extra-renal Losses: • Normal Acid-Base: Low intake • Metabolic acidosis: Gl tract
- Differential Diagnosis ... Algorithm Extra-renal ... loss (Diarrhea) Renal ... #Algorithm #causes ... #nephrology
Hyponatremia Diagnosis Algorithm UOsm ≥ POsm - Vasopressin-Dependent • UNa < 20 mEq/L - Appropriate (↓ EABV)
Hyponatremia Diagnosis ... Algorithm UOsm ... Primary polydipsia, Low ... solute intake, Renal ... #causes #nephrology
Causes of Metabolic Alkalosis - Differential Diagnosis Algorithm GI Losses - Gastric • Vomiting • NG suction GI
Causes of Metabolic ... - Differential Diagnosis ... Algorithm GI Losses ... MetabolicAlkalosis #NonGap #Nephrology ... #Algorithm #Causes
Hyponatremia - Differential Diagnosis Algorithm ADH Independent: • Tea and Toast Syndrome, Beer Potomania - Low solute
- Differential Diagnosis ... Algorithm ADH ... Beer Potomania - Low ... #Algorithm #causes ... #nephrology
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm Volume Depleted - 2° hyperaldosteronism • Low Urine Cl-: Vomiting,
- Differential Diagnosis ... Algorithm Volume ... hyperaldosteronism • High PRA: Renal ... #Algorithm #Nephrology ... #Causes
Approach to Hypomagnesemia Fractional excretion of magnesium = (urine magnesium x serum creatinine)/ [0.7 (serum magnesium
cells FEMg >4% = renal ... Hypomagnesemia #algorithm ... #differential #diagnosis ... #causes #nephrology ... #magnesium #low
Causes of Non-Gap Metabolic Acidosis - Differential Diagnosis Algorithm Normal Anion Gap (<14) (Loss of Bicarbonate) -
Causes of Non-Gap ... Diarrhea • Fistula Renal ... Cell Problem - Low ... MetabolicAcidosis #NonGap #Nephrology ... #Algorithm #Causes
Membranoproliferative Glomerulonephritis (MPGN) AKA: Mesangiocapillary GN • Active Urine Sediment (dysmorphic RBC, RBC casts, +/- proteinuria)
dysmorphic RBC, RBC casts ... proliferation • Double contour ... immune deposits on EM ... Glomerulonephritis #MPGN #nephrology ... #diagnosis #renal
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