renal

EM@3AM: Nephrotic Syndrome

A 25-year-old female with no significant past medical history presents with progressive periorbital and lower extremity edema for one week. She denies recent fever, chest pain, shortness of breath, allergies, or recent travel. Vitals include BP 120/90, HR 90, RR 18, Temp 98.7F. Exam shows a developmentally normal female in no acute distress. She has bilateral pitting edema up to knees without skin changes, but the rest of the exam is normal. Her pregnancy test is negative. What is the likely diagnosis?

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EM@3AM: Peritoneal Dialysis Emergencies

A 42 year-old male presents with abdominal pain and fevers for 72 hours, with nausea and vomiting for 24 hours. He has a history of ESRD and has been on peritoneal dialysis for 5 years. Triage vital signs (VS): BP 105/60, HR 121, T 101.4 temporal, RR 24, SpO2 98% on room air. Pertinent physical examination findings include a tender peritoneal dialysis site and diffuse abdominal tenderness, but no erythema overlying the PD site. What’s the next step in your evaluation and treatment?

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