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Pulmonary Renal Syndrome: Investigations and Management

#Pulmonary #Renal #Syndrome #Diagnosis #Workup #Management
Pulmonary Renal ... Syndrome: Investigations ... #Pulmonary #Renal ... #Syndrome #Diagnosis ... #Workup #Management
Evaluation of Secondary Hypertension
 • Primary aldosteronism - PRA, PAC
 • Renal artery stenosis - Renal
- PRA, PAC • Renal ... artery stenosis - Renal ... fT4 • Cushing syndrome ... Mineralocorticoid excess syndromes ... resistant #Evaluation #workup
Hypernatremia - Differential Diagnosis Workup Algorithm

1) Check Urine Osmolality:
 > 600 mOsm/kg - Implies extrarenal mechanism
Differential Diagnosis Workup ... mOsm/kg - Implies renal ... , Ingestion Renal ... Hypervolemic: Conn syndrome ... , Cushing syndrome
Hypomagnesemia - Etiologies by Mechanism

Decreased GI Uptake 
 - Poor dietary intake (particularly common in alcoholics)
diarrhea / IBD Renal ... - Transient renal ... - Familial renal ... Mg wasting syndromes ... Classification #Causes #Workup
Hypernatremia Diagnosis and Workup

Step 1 . Repeat the sodium concentration.
Step 2.  Check plasma osmolality.
NORMAL PLASMA
Diagnosis and Workup ... HYPOVOLEMIC • extra-renal ... - fevers • renal ... • nephrotic syndrome ... • renal failure
Hypokalemia - Differential Diagnosis Algorithm
Extra-renal Losses:
 • Normal Acid-Base: Low intake
 • Metabolic acidosis: Gl tract
Algorithm Extra-renal ... loss (Diarrhea) Renal ... : Proximal and distal ... SAME, Cushing Syndrome ... , Gitelman syndrom
Acute Kidney Injury - AKI Workup Algorithm and Differential Diagnosis
Baseline Investigations: full blood count with differential,
urinary sediment, renal ... HIV serology, renal ... eosinophiluria, renal ... protein-electrophoresis, renal ... markers • Cardio-renal
Localization of Renal Tubular Defects
Fanconi Syndrome: Proximal tubule
Bartter Syndrome: Thick ascending loop of Henle
Gitelman Syndrome: Distal
Localization of Renal ... Defects Fanconi Syndrome ... tubule Bartter Syndrome ... Henle Gitelman Syndrome ... : Distal convoluted
Hypertension and Altered Mental Status (AMS) - Differential Diagnosis Framework

Hypertension:
 • Hypertensive emergency
 • Hypertensive encephalopathy
• Cushing’s syndrome ... Pre-Eclampsia Renal ... Acute/Chronic renal ... failure • Renal ... • Scleroderma renal
Pulmonary Renal Syndromes and Mimics - Differential Diagnosis Framework
Diffuse alveolar hemorrhage + rapidly progressive glomerulonephritis
90%:
 -
Pulmonary Renal ... Syndromes and Mimics ... Levels: Scleroderma Renal ... AnnKumfer #Pulmonary #Renal ... #Syndromes #Mimics