Red Warnings(Never To Miss)

Question 1

Flank pain in elderly
Flank pain in young lady

In all women of child bear-ing age with loin pain consider possibility of ectopic pregnancy

Answer 1

In patients over 55 years of age with loin pain but no other symptoms of UTI consider acute abdominal AORTIC ANEURYSM and ask for an urgent surgical opinion

Question 2

Heparine dosing during dialysis

Answer 2

An initial dose of heparin (10–50 units/kg, usually 50 units/kg) is bolus injected just after needle insertion into the arteriovenous fistula or through a central venous catheter (Santos and Peixoto 2008).

A continuous dose of heparin (500–1500 units/h, usually 1000 units/h) is administered during the session of hemodialysis

Question 3

Low Dialysate ca side effects

Answer 3

A dialysate calcium concentration less than 1.25 mmoL/L (2.5 mEq/L) could cause increased risk of sudden cardiac death (Pun et al. 2013). Therefore, low dialysate calcium should be pre-scribed with care, most often to prevent vascular or soft tissue calcification and hypercalcemia due to secondary hyperparathyroidis

Question 4

High dialysate ca side effects

Answer 4

However, treatment with a high concentration of dialysate calcium carries the risk of vascular cal-cification, cardiovascular death in patients with calcium-based phosphate binder, over suppression of parathyroid hormone, adynamic bone disease, and hypercalcemia