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(A and B) Renal sonogram at presentation negative for hydronephrosis or nephrolithiasis. (C) Non-contrast computed tomography (CT) scan demonstrating a stone in the right kidney (arrow). No hydronephrosis is evident.

Illusion, Suspicion, and Obstruction: An Intriguing Case of Acute Kidney Injury

A 63-year-old man with a history of nephrolithiasis and neurogenic bladder requiring chronic indwelling urinary catheter was admitted for the management of urinary tract infection and acute kidney injury (AKI) with a serum creatinine level of 3.6 mg/dL (baseline approximately 1.9-2.2). He was initially brought to the emergency room for altered mental status. The patient […]

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Point-of-Care Ultrasound for the Assessment of Digital Clubbing

  Digital clubbing, a resultant finding from the proliferation of connective tissue in the terminal portion of fingers or toes, has long been recognized as a sign for a number of underlying infectious, inflammatory, malignant, and vascular conditions.1 A profile angle >176° and a hyponychial angle >192° support the diagnosis of clubbing.1Quantification of these angles can […]

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Abdominal computed tomography scan in the axial plane with contrast injection demonstrating entrapment of the right ureter (arrow) between right (6.1 cm) and left (13 cm) iliac artery aneurysms with peripheral calcifications.

A Dangerous Entrapment: Pelvic Aneurysms Causing Hydronephrosis

A 75-year-old patient with end-stage kidney disease on chronic hemodialysis was admitted with fever (38.5°C) and rigor. He was a heavy smoker and had long-standing diabetes and hypertension with abdominal aortic aneurysm (repaired 16 years prior with aortobifemoral graft) and peripheral artery disease with left above-knee amputation. Soon after admission, his blood pressure dropped and […]

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Pelvic computed tomography scan showed a heterogeneous mass with central necrosis (star) compressing and invading the urinary bladder. A Foley catheter (arrow) can be seen within the residual portion of the bladder.

Pneumaturia and Nephrotic Syndrome Caused by a HiddenPelvic Malignancy

A 78-year-old female was admitted to the cardiac critical care unit with concerns for acute on chronic heart failure exacerbation. She had a history of nonischemic cardiomyopathy that had previously remained stable over a period of 15 years through standard medical management. Six months prior to admission, she developed dyspnea and lower extremity edema. She […]

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Magnetic resonance imaging brain scan with contrast. (A) Axial view showing (arrow) transverse and sigmoid sinus venous thrombosis. (B) Axial view showing (arrow) left ophthalmic vein thrombosis. (C) Sagittal view showing (arrow) left ophthalmic vein thrombosis. (D) Axial view showing (arrow) focal perichiasmatic enhancement of the left optic nerve.

Lesson Learned Through a Case of Pneumococcal Meningitis: Sometimes Doing Less Is More Harmful

Pneumococcal meningitis is commonly associated with intracranial complications. We present a case of pneumococcal meningitis leading to partial loss of vision in the left eye secondary to vascular complications. A 62-year-old African American female with a past medical history of breast cancer and hypothyroidism presented with complaints of altered mental status, neck pain, headache, and […]

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Computer tomography without contrast of abdomen showing colonic distension with air fluid levels without mechanical obstruction.

Hypokalemia in an End-Stage Renal Disease Patient

Kidneys play an essential role in K+ homeostasis, but the role of the colon in K+ homeostasis is not well recognized. Increased colonic K+ excretion plays a vital role in regulating plasma K+ level in patients with end-stage renal disease.1 We present a case of hypokalemia in a patient with end-stage renal disease with colonic pseudo-obstruction. […]

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