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! align="center" style="background:#4479BA; color: #FFFFFF;" |Haematuria/Proteinuria
! align="center" style="background:#4479BA; color: #FFFFFF;" |Haematuria/Proteinuria
! align="center" style="background:#4479BA; color: #FFFFFF;" |Edema
! align="center" style="background:#4479BA; color: #FFFFFF;" |Edema
| align="center" style="background:#4479BA; color: #FFFFFF;" |CBC
! align="center" style="background:#4479BA; color: #FFFFFF;" |CBC
| align="center" style="background:#4479BA; color: #FFFFFF;" |KFT
! align="center" style="background:#4479BA; color: #FFFFFF;" |KFT
| align="center" style="background:#4479BA; color: #FFFFFF;" |Electrolytes
! align="center" style="background:#4479BA; color: #FFFFFF;" |Electrolytes
| align="center" style="background:#4479BA; color: #FFFFFF;" |Urine analysis
! align="center" style="background:#4479BA; color: #FFFFFF;" |Urine analysis
| align="center" style="background:#4479BA; color: #FFFFFF;" |ABG
! align="center" style="background:#4479BA; color: #FFFFFF;" |ABG
| align="center" style="background:#4479BA; color: #FFFFFF;" |Other
! align="center" style="background:#4479BA; color: #FFFFFF;" |Other
| align="center" style="background:#4479BA; color: #FFFFFF;" |Ultrasound
! align="center" style="background:#4479BA; color: #FFFFFF;" |Ultrasound
| align="center" style="background:#4479BA; color: #FFFFFF;" |X-ray
! align="center" style="background:#4479BA; color: #FFFFFF;" |X-ray
| align="center" style="background:#4479BA; color: #FFFFFF;" |CT
! align="center" style="background:#4479BA; color: #FFFFFF;" |CT
| align="center" style="background:#4479BA; color: #FFFFFF;" |MRI
! align="center" style="background:#4479BA; color: #FFFFFF;" |MRI
| align="center" style="background:#4479BA; color: #FFFFFF;" |Other
! align="center" style="background:#4479BA; color: #FFFFFF;" |Other
|-
|-
! rowspan="23" style="background:#4479BA; color: #FFFFFF;" |Prerenal
! rowspan="23" style="background:#4479BA; color: #FFFFFF;" |Prerenal
|[[Alcohol poisoning]]<ref name="pmid15589492">{{cite journal |vauthors=Pletcher MJ, Maselli J, Gonzales R |title=Uncomplicated alcohol intoxication in the emergency department: an analysis of the National Hospital Ambulatory Medical Care Survey |journal=Am. J. Med. |volume=117 |issue=11 |pages=863–7 |date=December 2004 |pmid=15589492 |doi=10.1016/j.amjmed.2004.07.042 |url=}}</ref><ref name="pmid2927129">{{cite journal |vauthors=Cherpitel CJ |title=Breath analysis and self-reports as measures of alcohol-related emergency room admissions |journal=J. Stud. Alcohol |volume=50 |issue=2 |pages=155–61 |date=March 1989 |pmid=2927129 |doi= |url=}}</ref><ref name="pmid12510444">{{cite journal |vauthors=Yost DA |title=Acute care for alcohol intoxication. Be prepared to consider clinical dilemmas |journal=Postgrad Med |volume=112 |issue=6 |pages=14–6, 21–2, 25–6 |date=December 2002 |pmid=12510444 |doi= |url=}}</ref><ref name="pmid10452451">{{cite journal |vauthors=Boba A |title=Management of acute alcoholic intoxication |journal=Am J Emerg Med |volume=17 |issue=4 |pages=431 |date=July 1999 |pmid=10452451 |doi= |url=}}</ref>
|[[Alcohol poisoning|'''Alcohol poisoning''']]<ref name="pmid15589492">{{cite journal |vauthors=Pletcher MJ, Maselli J, Gonzales R |title=Uncomplicated alcohol intoxication in the emergency department: an analysis of the National Hospital Ambulatory Medical Care Survey |journal=Am. J. Med. |volume=117 |issue=11 |pages=863–7 |date=December 2004 |pmid=15589492 |doi=10.1016/j.amjmed.2004.07.042 |url=}}</ref><ref name="pmid2927129">{{cite journal |vauthors=Cherpitel CJ |title=Breath analysis and self-reports as measures of alcohol-related emergency room admissions |journal=J. Stud. Alcohol |volume=50 |issue=2 |pages=155–61 |date=March 1989 |pmid=2927129 |doi= |url=}}</ref><ref name="pmid12510444">{{cite journal |vauthors=Yost DA |title=Acute care for alcohol intoxication. Be prepared to consider clinical dilemmas |journal=Postgrad Med |volume=112 |issue=6 |pages=14–6, 21–2, 25–6 |date=December 2002 |pmid=12510444 |doi= |url=}}</ref><ref name="pmid10452451">{{cite journal |vauthors=Boba A |title=Management of acute alcoholic intoxication |journal=Am J Emerg Med |volume=17 |issue=4 |pages=431 |date=July 1999 |pmid=10452451 |doi= |url=}}</ref>
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Revision as of 14:05, 2 May 2018


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Differential Oliguria

Classification by etiology Etiology Clinical manifestations Paraclinical findings Comments
Symptoms and signs Lab findings Imaging
Fatigue/Lethargy Thirst Dizziness/Confusion Muscle weakness/cramp Somatic/visceral pain Vomiting Diarrhea Tachypnea Haematuria/Proteinuria Edema CBC KFT Electrolytes Urine analysis ABG Other Ultrasound X-ray CT MRI Other
Prerenal Alcohol poisoning[1][2][3][4] + - +/- - +/- + +/- - - - Prolonged PT Elevated creatinine with normal BUN may indicate isopropyl alcohol poisoning - - - - - - -
Aspergillosis[5][6][7] +/- - - - - - - +/- - - - - - - - -
  • Pulmonary infiltrates
  • Mucoid plugging
  • Central bronchiectasis
  • Mass in the upper lobe surrounded by a crescent of air
  • Solitary or multiple cavities
  • Halo sign (ground-glass appearance with nodules)
  • Defines bronchiecstasis
  • May show evidence of wedge-shaped pulmonary infarction
  • Granulomata, tissue necrosis, and blood vessel invasion may be noted
- -
Cholera[8][9][9][10] +/- + - - - +/- + - - - -
  • Stool is used in dark field examination or PCR to visualize treponema pallidum
  • Stool culture is carried out using thiosulfate-citrate-bile-sucrose-agar
  • Serotyping may be performed using an anti-serum
  • Elevated serum protein is noted
  • Elevated serum-specific gravity is noted
  • Elevated blood glucose may be detected
- - - - -
Congestive heart failure (CHF)[11][12][13][14][15][16] + - - - - - + - - - - -
Dehydration[17][18][19][20]

- Burns

-Cutaneous loss e.g. sweating

- Inadequate water intake

- Salt-wasting nephropathy

+ + - +/- - +/- +/- - - - -
  • Ketones and glucose] may be detected
  • Urine specific gravity is elevated
- - - - -
Diarrhea and/or vomiting[21][22][23][24] +/- +/- - - - + + - - - -
  • Stool anion gap should be calculated
-
  • Abdominal ultrasound may be useful to detect cause
  • Upper gastrointestinal radiography with follow-through may be useful to detect cause
-
  • Brain MRI may be useful to detect cause
  • Esophagogastroduodenoscopy may be useful to detect cause
  • Treatment must include volume replacement
Drugs/toxins[25][26][27][28]

- ACE inhibitor

- Aminoglycosides

- Amphotericin B

- Contrast material

- Cyclosporin

- Diuretics

- Digitalis

- Heavy metals

- Indomethacin

- Tacrolimus

- NSAIDs

+/- +/- +/- +/- +/- +/- +/- +/- +/- +/- -
  • Blood glucose should be measured
  • Toxicology screening is crucial in aiding diagnosis
  • Rapid immunoassay screens may also aid diagnosis
  • Useful in drug-induced nephropathies
  • Some radio-opaque substances may be visualized
  • Ingested drug packets may also be visualized
- -
Esophageal varices bleeding[29][30] +/- - - - +/- - - - - - - - - -
  • Duplex doppler ultrasonography can determine:
    • Velocity and direction of portal flow
    • Determine portal vein patency
  • Endoscopic ultrasonography may also be useful
  • Abnormal opacities representing paraesophageal varices may be detected outside the esophageal wall
  • The short or long segment of the descending aorta may be obliterated
  • A posterior mediastinal or intraparenchymal mass may be noted
  • A dilated azygous vein may be noted and is described as a "downhill varix"
  • Dilated collaterals may lead to a widened superior mediastinum
  • Barium swallow demonstrates snake-like filling defects
  • Can visualize the entire portal venous system
Heart disease[31][32][33]

-Congenital

-Acquired

+/- - - - - - - +/- - +/- - - -
  • For coronary heart disease, cardiac stress testing may be performed:
  • For rheumatic heart disease, the following tests may be performed:
    • Throat culture may be positive for group A beta hemolytic streptococcus
    • Rapid antigen detection test may be positive for group A streptococcal antigen
    • Antistreptococcal antibodies may be detected
    • Heart reactive antibodies may be detected against M protein
    • Rapid detection test for D8/17 B cell markers
  • Hyperoxia test can distinguish cardiac from non - cardiac causes of cyanosis
  • Pulse oximetry is useful in congenital heart diseases
  • Ultrasound visualizes anatomy of the heart and in particular, the chambers and chamber flow
- -
  • History and physical examination (auscultation of the heart) are important for diagnosis
Hemorrhage[34][35][36][37] - - - - - - - - - - - - -
  • Sensitive to bleeding within body cavities
  • Focused abdominal sonographic technique (FAST) can detect peritoneal cavity fluid
  • Chest x - ray may demonstrate bilateral opacities in the lung field and indicate hemothorax
  • Abdominal x - ray may demonstrate hemoperitoneum
  • Incomplete calcified margins of a dilated aorta may indicate a ruptured abdominal aortic aneurysm
  • Absence of the psoas shadow may suggest retroperitoneal blood
  • May visualize intrathoracic, intra-abdominal, and retroperitoneal bleeding
  • However, ultrasound is more often used
-
  • Esophagogastroduodenoscopy is often used to visualize the source of bleeding in the upper GI
  • Colonoscopy may be used in the lower GI
  • Angiography and nuclear medicine scanning are also useful in diagnosing the source of bleeding
Hemolysis[38][39][40][41] +/- - - - - - - - +/- - - - - - - - - -
Hepatorenal syndrome[42][43][44][45] +/- - - - +/- +/- - - +/- +/- -
  • Abdominal ultrasound to exclude hydronephrosis and intrinsic renal disease
- - -
  • Echocardiography is used to evaluate right ventricular preload, ventricular filling pressures, and cardiac function
Ischemic cardiomyopathy[46][47][48][49] +/- - - - - - - +/- - +/- - - -
  • May detect abnormal cardiac silhouette
  • MRI with gadolinium–diethylene-triamine pentaacetic acid (DTPA) can evaluate mid-wall fibrosis
Liver cirrhosis[50][51][52] +/- - +/- +/- +/- - - - - +/- - - - - -
Malignant hypertension[53][54] +/- - + - - +/- - +/- - +/- - - -
  • Electrocardiography may indicate the following:
    • Ischemia
    • Infarct
    • Evidence of electrolyte abnormalities or drug overdose
  • Echocardiography may indicate the following:

References

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  2. Cherpitel CJ (March 1989). "Breath analysis and self-reports as measures of alcohol-related emergency room admissions". J. Stud. Alcohol. 50 (2): 155–61. PMID 2927129.
  3. Yost DA (December 2002). "Acute care for alcohol intoxication. Be prepared to consider clinical dilemmas". Postgrad Med. 112 (6): 14–6, 21–2, 25–6. PMID 12510444.
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