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Pulmonary Renal Syndrome

Definition: Diffuse alveolar hemorrhage + Glomerulonephritis
Presentation (Pulmonary and renal manifestations can occur weeks apart):
Pulmonary Renal ... can occur weeks ... Renal Syndromes ... infiltrates) → high ... #Renal #Syndrome
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
Algorithm Extra-renal ... loss (Diarrhea) Renal ... • HTN, High Aldosterone ... , Gitelman syndrom ... potassium #low #nephrology
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting, NGT
Diuretics (late) • High ... , Gitelman Syndrome ... hyperaldosteronism • High ... PRA: Renal artery ... Diagnosis #Algorithm #nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... • Drugs • Pulmonary ... GI losses • Renal ... • Nephrotic syndrome
Primary Metabolic Alkalosis - Differential Diagnosis Algorithm
Volume Depleted - 2° hyperaldosteronism
 • Low Urine Cl-: Vomiting,
Diuretics (late) • High ... , Gitelman Syndrome ... hyperaldosteronism • High ... PRA: Renal artery ... Diagnosis #Algorithm #Nephrology
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Diagnosis Algorithm Syndrome ... Pain/Post-op • Neurologic ... • Drugs • Pulmonary ... GI losses • Renal ... • Nephrotic syndrome
Hyponatremia - Differential Diagnosis Algorithm
ADH Independent:
 • Tea and Toast Syndrome, Beer Potomania - Low solute
Tea and Toast Syndrome ... Treat with a high ... • Renal Failure ... failure, nephrotic syndrome ... Algorithm #causes #nephrology
Pulmonary Renal Syndromes - OnePager Summary
Autoimmune ANCA vasculitis (AAV): GPA (granulomatous with polyangiitis), EGPA (eosinophilic granulomatosis
Pulmonary Renal ... Syndromes - OnePager ... Renal Syndromes ... defining feature, PRS can ... #Renal #Syndromes
Causes of Metabolic Alkalosis - Differential Diagnosis Algorithm
GI Losses - Gastric
 • Vomiting
 • NG suction
GI
Chloridorrhea Renal ... • Penicillins Renal ... Tumor Low Renin, High ... Licorice • Liddle's Syndrome ... MetabolicAlkalosis #NonGap #Nephrology
High Anion Gap Metabolic Acidosis (HAGMA) - Differential Diagnosis - GOLDMARK

Glycols - ethylene and propylene glycol
Oxoproline
High Anion Gap Metabolic ... with short bowel syndrome ... ketoacidosis Renal ... acids in advanced renal ... GOLDMARK #mnemonic #nephrology