renal

MDM – AKI/Dehydration

MDM

Mild, Discharge: 

This patient presents with generalized weakness and fatigue likely secondary to dehydration. Suspect acute kidney injury of prerenal origin. Doubt intrinsic renal dysfunction or obstructive nephropathy. Considered alternate etiologies of the patient’s symptoms including infectious processes, severe metabolic derangements or electrolyte abnormalities, ischemia/ACS, heart failure, and intracranial/central processes but think these are unlikely given the history and physical exam.

Plan: labs, ***fluid resuscitation, pain/nausea control, reassessment

DC Inst – Renal Colic

DC

You have been evaluated in the Emergency Department today for your flank pain. Your pain is most likely due to a kidney stone which will pass on its own.

We recommend you take 600mg ibuprofen every 6 hours or tylenol 650mg every 6 hours as needed for pain. If needed, you can alternate these medications so that you take one medication every 3 hours. For instance, at noon take ibuprofen, then at 3pm take tylenol, then at 6pm take ibuprofen.

Please follow up with your primary care physician within two days.

Return to the Emergency Department if you experience worsening pain, fever, painful urination, blood in urine, weakness, chest pain, difficulty breathing or any other concerning symptoms.

Thank you for choosing us for your care.

Pyelonephritis – General

MDM

Patient presenting with flank pain and fever. Differential included UTI, pyelonephritis, diverticulitis, nephrolithiasis, appendicitis. Also considered but less likely given history and physical exam included constipation, bowel perforation, gastritis, pancreatitis, mesenteric ischemia. Patient febrile and provided with tylenol.

Plan: labs, UA/cx, bedside ultrasound for hydro/stone, ***CT A/P, pain control, reassessment, antibiotics, anticipate admission/discharge