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Common ultrasound abnormalities seen on kidney and urinary bladder POCUS

- Dr. Abhilash Koratala MD - NephroPOCUS
kidney and urinary bladder ... NephroP #kidney #bladder ... pocus #ultrasound #renal
Acute Kidney Injury (AKI) - Differential Diagnosis Framework
Pre-Renal:
 • Hypovolemia, Cardiorenal, Distributive Shock, HRS, Hypercalcemia, Renal
Framework Pre-Renal ... Hypercalcemia, Renal ... Medications Intra-Renal ... Autoimmune Post-Renal ... • Neurogenic Bladder
VExUS - Venous Excess Ultrasound Score 

The Venous Excess UltraSound (VExUS) grading system prototypes combining inferior
diameter and venous Doppler ... and interlobular renal ... Hepatic Doppler ... Portal Doppler is ... Intra-renal venous
Hematuria - Differential Diagnosis Framework

Gross Hematuria: Red/Dark urine
 • 1ml blood/liter urine can induce color change
thrombosis • Renal ... gross hematuria Bladder ... • Cystitis • Bladder ... TURP/Biopsy Renal ... /Ureter/Bladder
Acute Kidney Injury (AKI) - Differential Diagnosis Framework

PRE-Renal AKI:
 • Hypovolemia
 • Congestion
 • Medications
 •
Framework PRE-Renal ... Shunting INTRA-Renal ... Drug-induced POST-Renal ... obstruction, Neurogenic bladder
Renal Infarction on POCUS

An illustrative case of renal infarction: Note that there is almost no color
Renal Infarction ... illustrative case of renal ... Absent power Doppler ... consistent with renal ... NephroPOCUS @NephroP #Renal
Bladder Stone with Twinkle Artifact on POCUS
Twinkle artifact isn't just for renal stones, check out this
Bladder Stone with ... isn't just for renal ... check out this bladder ... @CincySono #Bladder ... ultrasound #clinical #doppler
Guide to Acute Kidney Injury (AKI)

What to ask/look for: 
 - HPI, PMH, full ROS
protein/Cr - Renal ... /bladder US w/ PVR ... - 45% - Pre-renal ... mostly ATN and pre-renal
Twinkle Sign - Bladder Stone on Doppler Ultrasound

Obstructive uropathy is evidenced on POCUS by hydronephrosis, but
Twinkle Sign - Bladder ... Stone on Doppler ... hydronephrosis, but renal ... erratic color doppler ... Twinkle #Sign #Bladder
Algorithm and Differential Diagnosis of Macroscopic Hematuria
Important Historical Elements:
- Painless: suggests malignancy
- Painful: suggests calculi/infection
- Urinalysis:
suggest intrinsic renal ... tract), terminal (bladder