Comments on: What’s the Diagnosis #15

By: ST

ST — Fri, 25 Jan 2013 14:06:36 +0000

Just curious, what was his K+ value?

By: NYCMedic

NYCMedic — Tue, 22 Jan 2013 18:54:16 +0000

Haha, he’s eating is words now. HyperK is clearly NOT the zebra diagnosis.

By: KT

KT — Mon, 21 Jan 2013 09:33:23 +0000

PS. WC…dialysis unit was using a shunt?? What century is this! ;p

By: dilaudid distributor

dilaudid distributor — Sun, 20 Jan 2013 02:44:36 +0000

And I’ve seen, and I’ve seen, and I’ve seen dialysis patients skip for weeks and be ok. Can’t discount the other symptoms. I did throw in other support with the ekg. Go straight for the zebra on limited data, should have seen that right away. Fairly similar to the retrospectroscope mentality we all seem to live in now.

By: KT

KT — Sat, 19 Jan 2013 09:24:46 +0000

I’ve given a person 5hrs dialysis one night, and spent the next afternoon dialysing that exact same patient in coronary care. Not saying this is hyperkalaemia (haven’t had to read an ecg since I finished uni), however it’s not safe to rule out anything based on recent dialysis. You don’t get diabetic nephropathy from being compliant.

By: dilaudid distributor

dilaudid distributor — Sat, 19 Jan 2013 01:51:52 +0000

Aortic aneurysm with extension into the carotid arteries. Not hyper K given the recent dialysis, and no peaked t-waves. Taught once the criteria for peaked t-waves was if you would sit on them or not. Would sit on all but maybe V3.

By: andrea

andrea — Fri, 18 Jan 2013 22:55:46 +0000

Aortic dissection. LE weakness from anterior spinal cord ischemia (artery of Adamkew…however it is spelled). Upper back pain classic for dissection. ST elevations due to dissection into coronary artery.
That would be a big ass dissection, though.

By: Jason

Jason — Fri, 18 Jan 2013 15:58:31 +0000

I’m with VinceD

By: Ajr

Ajr — Fri, 18 Jan 2013 03:52:58 +0000

LV aneurysm. S/p previous MI.

By: hashmd

hashmd — Thu, 17 Jan 2013 19:48:48 +0000

Hyperkalemia. Needs dialysis