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Russell Dolan, MD Profile picture
Russell Dolan, MD
@dolan_russell
GI at Wilmington GI | Former GI Fellow @BrighamGI @harvardmed | Internal Medicine Resident @UMichMedicine | Emory School of Medicine Alumnus | @UMich #GoBlue
Reza Hosseini, MD MPH Profile picture 1 subscribed
Apr 16, 2019 • 25 tweets • 7 min read
1: What causes WBC/PMN elevation (neutrophilic-predominant pleocytic) ascites? The differential is broad and extends beyond Spontaneous Bacterial Peritonitis (SBP).

(A #MedTwitter and #Tweetorials contribution). Appreciate edits by @ebtapper. 2: 26yoW w/ cirrhosis 2/2 congestive hepatopathy 2/2 hypoplastic L heart syndrome s/p Fontan presented to OSH with fevers, abdominal pain. Prev tx by PCP for ?PID w/ IM CTX, doxycycline. Dx para shows WBC 2480, PMN 74%, total protein 4.3, SAAG >1.1. What is cause of ascites here?
Mar 5, 2019 • 19 tweets • 5 min read
1: What causes triglyceride elevation in pleural fluid studies?

My previous understanding of this diagnostic test was recently challenged and lends credence to the fascinating diversity of pleural effusions/dz.

(A #MedTwitter and #Tweetorials contribution). 2: A middle aged woman OSH patient was transferred with LEFT pleural effusion that developed 5 days post-CABG.

Initial pleural fluid studies:
protein <0.8 LDH 2300 glucose 278 RBC 400 WBC 17.5k trigs 204 cholesterol 225 chylomicrons (-)

What type of effusion is this?