Lithium Overdose: The tale of a light metal and its skinny therapeutic index Chief Complaint: Lithium Overdose HPI: Patient is a 39-year-old male with a past medical history of schizoaffective disorder, alcohol abuse, and prior suicide attempt by drug overdose who presents today due to another suicide attempt. Patient states that his girlfriend recently passed…
Read MoreAuthor: Gretchen Hinson, MD Educational Pearls: In most healthcare settings, normal saline (NS) has become ubiquitous as an intravenous fluid despite some potential drawbacks Compared to normal saline, a balanced crystalloid (either lactated Ringer’s or Plasma-Lyte) was associated with a lower composite endpoint of mortality, renal replacement therapy, and renal injury in SMART (Isotonic Solutions…
Read MoreAuthor: Don Stader, MD Educational Pearls: Recent meta-analysis has demonstrated that there is no significant risk for kidney injury from CT contrast Most kidney injury seen after contrast CTs were due to other underlying illnesses (sepsis, hypovolemia, etc.) Older contrast agents likely did have nephrotoxic effects but this appears to be a thing of…
Read MoreAuthor: Erik Verzemnieks, MD Educational Pearls: Single study in Japan demonstrated possible effectiveness of renal colic trigger point Patients had injection at the area of maximal tenderness on palpation of the flank Compared to a muscle relaxer, injection of local anesthetic at the trigger point had faster time to pain relief and fewer rescue therapies…
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