omg.. my blog!
Wow.. i totally forgot about this project.. sorry for anyone who actually reads this :)
Im kinda worked to the bone.. but thats ok..
so Im on the renal/nephrology service which is of course what i want to do with my life.. so everything is going well. Really really tired, its a really busy service.
But here some interesting stuff..
40 yrs old male got Diabetes, lost his kidneys.. got transplanted.. now came in wiht 30 lbs of weght gain and shortness of breath. So ur kidneys are responsible for fluid control.. got no kidneys.. u ll blow up like a balloon.. but this guy has a transplant therefore shouldnt be a problem for him. And heres the kicker.. his lungs are clear.. which is really really strange, cuz when u blow up with fluid.. usually the first place it deposits is in the lungs. (thats what most docs are listening for when they listen to ur back).. but his legs are filled with fluid.. u can press a whole inch into his fluid filled ("edematous") legs. All consistent with right heart failure. Usually ur left heart fails..and then fluid builds up in ur lungs..
Remember the travel of blood:
Left heart-> ur body -> right heart -> ur lungs-> left heart
if anything stops working ("failure") itll usually cause thing thing PRIOR to malfunction and back up with fluid.. hence right heart failure makes ur body fill with fluid and left heart failure makes ur lungs fill up. Right heart failure is pretty uncommon.. and its even more uncommon without associated left heart failure.
So why???? Answer: i dont know.. so we looked at his heart with an echocardiogram (an ultrasound of the heart).. he doesnt have low ouput on his left side (but we didnt expect that since he got clear lungs) and his right heart didnt look special either. Heres my idea now: Amylodosis. I think his heart is not filling properly, something u cant really detect will with echocardiogram. Amlyodosis is a condition where u have protein filling in the muscle in ur heart.
its just a thought.. but i think it might be it.. i was really out of ideas.
Well thats all i got time for..
wow a day off feels good :)
Atif
Im kinda worked to the bone.. but thats ok..
so Im on the renal/nephrology service which is of course what i want to do with my life.. so everything is going well. Really really tired, its a really busy service.
But here some interesting stuff..
40 yrs old male got Diabetes, lost his kidneys.. got transplanted.. now came in wiht 30 lbs of weght gain and shortness of breath. So ur kidneys are responsible for fluid control.. got no kidneys.. u ll blow up like a balloon.. but this guy has a transplant therefore shouldnt be a problem for him. And heres the kicker.. his lungs are clear.. which is really really strange, cuz when u blow up with fluid.. usually the first place it deposits is in the lungs. (thats what most docs are listening for when they listen to ur back).. but his legs are filled with fluid.. u can press a whole inch into his fluid filled ("edematous") legs. All consistent with right heart failure. Usually ur left heart fails..and then fluid builds up in ur lungs..
Remember the travel of blood:
Left heart-> ur body -> right heart -> ur lungs-> left heart
if anything stops working ("failure") itll usually cause thing thing PRIOR to malfunction and back up with fluid.. hence right heart failure makes ur body fill with fluid and left heart failure makes ur lungs fill up. Right heart failure is pretty uncommon.. and its even more uncommon without associated left heart failure.
So why???? Answer: i dont know.. so we looked at his heart with an echocardiogram (an ultrasound of the heart).. he doesnt have low ouput on his left side (but we didnt expect that since he got clear lungs) and his right heart didnt look special either. Heres my idea now: Amylodosis. I think his heart is not filling properly, something u cant really detect will with echocardiogram. Amlyodosis is a condition where u have protein filling in the muscle in ur heart.
its just a thought.. but i think it might be it.. i was really out of ideas.
Well thats all i got time for..
wow a day off feels good :)
Atif
posted by AKJ at
10:37 AM
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