Let’s Talk About Bicarb

If you’re like me, when you treat hyperkalemia, you make things easy on yourself and open up that HyperK orderset, or think about the mnemonic C BIG K DROP (Calcium, beta-agonist/bicarb, insulin, glucose, Kayexalate (Lokelma actually)…

To send home or not – AC in nephrotic syndrome

This deep dive came from a question posed during a morning report by Jackson. Jackson presented the case of a patient presenting with a swollen penis at MSBI, found to have low albumin and diagnosed with nephrotic syndrome. These patients a…

ER venous panel or BMP?

You have a patient who is in acute renal failure. You have sent an ER-venous panel that shows a Cr of 4.6, a BUN of 95, and a K of 6.5. You discuss these findings with your nephrology colleagues who request you get the “more accurate” basic…

How much toradol?

Current FDA dosing for Toradol is 30mg IV and 60mg IM in patients < 65 years old.  But is that necessary? Let’s look at this randomized controlled trial: Motov S et al. Comparison of intravenous ketorolac at three single-dose regim…

Pregnancy Pain

A 29 y/o F 20 weeks pregnant presents with fever, dysuria, and left flank pain. She has some CVA tenderness on the right. WBC is elevated to 15. UA shows both blood and leukocytes in the urine. You are concerned about pyelonephritis vs. and…

Confused and Hypertensive

52 y/o female with a PMH of HTN and HLD presents with mental status change over the past 12 hours. She is non-compliant with medications and her initial BP is 252/130. Physical exam shows pt is A&Ox1, with an otherwise normal neuro exam…

June 2023