AIP: Abd pain + neuro/psych sx + autonomic instability (↑HR/↑BP) + dark urine + hyponatremia | Pupils reactive (≠ anticholinergic) | Triggers: Fluoxetine/alcohol/hormones | Dx: ↑urine PBG & porphyrins | Tx: Hemin + 10% glucose | Avoid porphyrogens | Watch: Resp failure/seizures

#Infodense #ClinicalPearl #MedicalLicensing

CNI nephrotoxicity (tacrolimus/cyclosporine): Immunosuppression – 2 classes: CNI, mTORi (sirolimus), GC (prednisone), purine synthesis inh (azathioprine, MMF) | Calcineurin inhibition → afferent arteriolar vasoconstriction → ↓ renal blood flow → ↑ Cr/BUN + HTN | Histo: Acute → tubular vacuolization; Chronic → obliterative vasculopathy, striped fibrosis, tubular atrophy | Rx: Dose ↓, switch to mTORi (sirolimus)

#Transplant #Pharmacology #MedEd #ClinicalPearl #DeepSeek #AIGenerated #2025 #Verify

Nephrogenic DI: polyuria (>3 L/day), polydipsia, dehydration despite adequate ADH
Causes: lithium, demeclocycline, foscarnet, amphotericin B, genetic (AQP2/V2R), hypercalcemia, hypokalemia, renal disease
Pathophys: ADH present but ↓ signaling → ↓ AQP2 insertion → ↓ water reabsorption in collecting ducts
Dx: urine SG <1.010, ± hypernatremia, no concentration after water deprivation (central DI would fully concentrate with DDAVP)

#MetaAI #MiniMedSchool #ClinicalPearl #NotMedicalAdvice #MedEd

If there was 1 thing I wish I could get all urgent cares to understand is to stop prescribing steroids with paxlovid. Not only are there DDIs between the 2,you also shouldn't be using steroids in the first week of covid as it can make things worse. The NIH recommends against there use in nonhospitalized patients. #meded #clinicalpearl #pharmacist

https://www.covid19treatmentguidelines.nih.gov/management/clinical-management-of-adults/nonhospitalized-adults--therapeutic-management/