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The Tale of the Low Chloride

Once there was 34 year old man who used marijuana and was 🤮nauseous, vomitting, and confused. The resident 📞calls and says, "All the electrolytes are abnormal!! Can you help?"

renalfellow.org/2019/12/16/ske…

@TheSkeletonKG #FOAMED #medtwitter #tweetorial Image
You say of course and see the patient. 🥼🩺His BP was 131/87 mmHg with a HR of 142 bpm. He was fatigued, but AOx3. Moist mucous membranes, normal skin turgor, and no LE edema.

💉Labs are shown and reveal a serum osmolality of 263 with ALL normal labs 3 months prior. Image
Loving Nephrology🤓, you ask, "What about the urine?!"

He is making urine with a urine Cl of < 20.

(💭Learn more about FeK and Urine K/Cr ratio with our previous case! renalfellow.org/2019/11/14/the… @hotsaltrocks ) Image
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