Medulla only! Some diagnoses can be made in medulla only biopsy ⁃ Myeloma kidney ⁃ Light/heavy chain deposition disease ⁃ Amyloid ⁃ Crystals ⁃ sometimes ATN, interstitial nephritis, pyelonephritis Case showing large number of uric acid crystals in medulla:Urate nephropathy

(1/x) We often focus on crazy POCUS cases that are so visually impactful (see this effusion 👇) but I am convinced that most of the benefit of POCUS is in its routine application for select populations. Let's take sepsis and see how POCUS upgrades our traditional assessment 🧵

Would you start an ARB in a patient with a history of ACE inhibitor-induced angioedema? #Nephpearls Re-post for YES ✅ Like for NO ❌

9/13 David's left hand is positioned just above the level of his heart. Notice that the hand veins are collapsed in this position, as they should be in someone with normal central venous pressure.

10/13 Here is a demonstration of the hand vein technique to evaluate central venous pressure.

When is #NephJC returning to X? I boycotted Best Buy for many years after I was wronged by warranty service, but I eventually returned.

Effect of Antihypertensive Drugs on Rapid Decline in Estimated Glomerular Filtration Rate in Japanese Patients With Chronic Kidney Disease The risk of rapid eGFR decline increased with increasing BP and decreased with controlling BP. Antihypertensive treatment was associated

Nebulized adrenaline for refractory bronchospasm. instagram.com/p/DL6NsAgKfZ2/

Rapid atrial swirl sign. #POCUS #Nephpearls #dialysis #FOAMed

What a fantastic #HCP webinar by Ross Prager Eduardo R Argaiz and Frederik H. Verbrugge on mastering diuresis. A few of the many things I learned and need to read up on below!

3. Dose Lasix based on a patient's GFR. The lower the GFR, the higher of a dose you need! 4. Choose your Lasix frequency based on how quickly and how much you want to diurese patients in a day (don't base frequency on the GFR)

Renal is a growing subspecialty within pathology that we want to expose more pathology residents and med students to. At Arkana, we regularly see rare diseases that most physicians don’t see in their entire careers. If you want unparalleled exposure to rare diseases, visit or

Flexor tenosynovitis is a clinical diagnosis (Kanaval signs!). Labs such as WBC, ESR, CRP should not be used to rule out FTS given poor sensitivity (39-76%) and negative predictive value (3-13%) X-ray is needed to look for foreign body or bony injury. Stream episode 3! 👌 #FOAMed

Acanthocyte - phase contrast (original mag x400) - from patient with hydralazine-induced vasculitis #UrineMicroscopy #UrinarySediment

WBC cast - brightfield and darkfield, with SM stain - from patient with hydralazine-induced vasculitis #UrineMicroscopy #UrinarySediment

RBC cast - brightfield, with SM stain - from patient with hydralazine-induced vasculitis #UrineMicroscopy #UrinarySediment

RBC's within waxy cast - brightfield and darkfield, unstained - from patient with hydralazine-induced vasculitis #UrineMicroscopy #UrinarySediment

RBC cast - brightfield, unstained - from patient with hydralazine-induced vasculitis #UrineMicroscopy #UrinarySediment

Sometimes, a single image is enough to diagnose severe venous congestion! #POCUS #VExUS #FOAMed #Nephpearls

Contraindicated together, particularly in patients who are older, volume-depleted, or have impaired kidney function, due to the increased risk of serious side effects, most notably acute kidney injury (AKI), also known as the "triple whammy".