Quiz of the day 08/08/2021

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Management of Acute Kidney Injury

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Objectives 1. Clinical diagnosis of acute kidney injury. 2. Identifying the aetiology of acute kidney injury. 3. Learn the complications of acute kidney injury. 4. Management of complications of acute kidney injury. 5. Basics of renal replacement therapy in acute kidney injury. 1.  Clinical diagnosis of acute kidney injury. Usual manifestations of acute kidney injury is oliguria (Reduced urine output). With the progression of renal impairment, patients develop various complications such as acidosis/ uremia which give rise to other manifestations. There are various criterions to diagnose AKI, you don't have to memorise those. Increase in S.Cr by >0.3 mg/dl (>26.5 umol/l) within 48 hours; or Increase in S.Cr to >1.5 times baseline, which is known or presumed to have occurred within the prior 7 days; or  Urine volume < 0.5 ml/kg/h for 6 hours. 2. Identifying the aetiology of acute kidney injury. You must be already knowing that acute kidney injur
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2 min read - Cirrhosis

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A 55 years old male patient admitted to medical casualty with a febrile illness for 3 days with myalgia. Examination was unremarkable. He was previously well except for chronic bilateral knee joint osteoarthritis. He consumed liquor quarter to half a bottle on a daily basis. Investigations revealed. WBC - 5.6 Hb - 11.2 Plt - 135 AST - 45 ALT - 42 S.Cr - 54 He was managed as viral fever and became fever free the next day. However the platelet count was persistently low around 130. Further investigations arranged. Blood picture - Thrombocytopenia probably due to liver disease S. Bilirubin, ALP - Normal S. Albumin - 38, S globulin - 37 USS abdomen - Coarse echogenicity of liver. Mild portal hypertension. Mild splenomegaly. Compatible with chronic liver cell disease. This patient has Cirrhosis with portal hypertension. Now the obvious cause for his cirrhosis is alcohol, isn't it? NO! Just because of the history of significant alcohol consumption you ca
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