Dr. Gerald Diaz @GeraldMD
48.6M 14.2K 7.5K
Board Certified Internal Medicine Hospitalist, GrepMed Editor in Chief πŸ‡΅πŸ‡­ πŸ‡ΊπŸ‡Έ - Sign up for an account to like, bookmark and upload images to contribute to our community platform. Follow us on IG: https://www.instagram.com/grepmed/ | Twitter: https://twitter.com/grepmeded/
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Hepatopulmonary Syndrome (HPS) 

HPS-differential diagnosis:
1. Pulmonary vasculature
2. Diseases of the lung parenchyma
3. Pleura and diaphragm

HPS-diagnosis:
1. Patients
Hepatopulmonary ... Syndrome (HPS) ... HPS-differential ... Pulmonary vasculature ... #Syndrome #HPS
Hepatopulmonary Syndrome (HPS) demonstrated on Echocardiogram Bubble Study

Intra-cardiac shunt: Bubbles appear in LA quickly (within 3
Hepatopulmonary ... Syndrome (HPS) demonstrated ... beats) Intra-pulmonary ... #HPS #Hepatopulmonary ... Study #clinical #POCUS
β–Ί
Pulmonary Renal Syndromes and Mimics - Differential Diagnosis Framework
Diffuse alveolar hemorrhage + rapidly progressive glomerulonephritis
90%:
 -
Pulmonary Renal ... - Differential ... , atypical HUS, ... Kumfer @AnnKumfer #Pulmonary ... #Mimics #Differential
Pharmacological Treatment of Hepatorenal Syndrome (HRS)

Midodrine - Alpha agonist incr blood pressure incr renal perfusion pressure
Pharmacological Treatment ... of Hepatorenal Syndrome ... #HepatoRenal #Syndrome ... #Nephrology #Management ... #Medications #Treatment
Pulmonary Renal Syndrome

Definition: Diffuse alveolar hemorrhage + Glomerulonephritis
Presentation (Pulmonary and renal manifestations can occur weeks apart):
Pulmonary Renal ... Syndrome Definition ... symptomatology Differential ... #differential # ... diagnosis #nephrology
Approach to the A-a Gradient
A-a gradient = PAO2 - PaO2
A-a gradient = [FiO2 x (Patm -
Hypoventilation Syndrome ... Intracardiac, Pulmonary ... AVMs, Hepatopulmonary ... Syndrome - ... Hypoxia #hypoxemia #differential
Hypophosphatemia Diagnostic Algorithm
- GI Losses
- Redistribution
- 1Β° HPT
- 1Β° Renal PO4 wasting: Hereditary, TIO, Fanconi Syndrome,
Redistribution - 1Β° HPT ... , TIO, Fanconi Syndrome ... diagnosis #Algorithm #differential ... #nephrology
Hypoxemic Respiratory Failure - Differential Diagnosis Framework
DECREASED INSPIRED OXYGEN
 β€’ Low PATM Can decrease first part
Respiratory Failure - Differential ... obesity-hypoventilation syndrome ... AVMs, hepatopulmonary ... syndrome), intracardiac ... Failure #hypoxia #Differential
Causes of Hyponatremia - Differential Diagnosis Algorithm
Syndrome of Inappropriate ADH - Euvolemic; no physiologic stimulus to
Hyponatremia - Differential ... Diagnosis Algorithm Syndrome ... β€’ Drugs β€’ Pulmonary ... #Hyponatremia #Nephrology ... #Differential #
Hepatorenal Syndrome Treatment
Volume expansion: 
 β€’ Albumin (typical dose = 1g/kg on day 1 +/- day
Hepatorenal Syndrome ... Treatment Volume ... #Hepatorenal #Syndrome ... #Treatment #management ... #HRS #nephrology