This article aims to give practical advice and general principles on how to manage electrolyte and acid-base disturbances, using two case studies as examples. All of these conditions are potentially very serious and without correct treatment are associated with significant morbidity and mortality. Correct treatment is crucial, as injudicious management can also have significant and potentially life-threatening consequences.
Renal stone disease accounts for a significant proportion of attendances to the urological, surgical and A&E departments. Consequently, it is highly likely that most trainees embarking on foundation training will encounter patients with renal stone disease either in the acute emergency setting or the outpatient setting. Knowledge of presenting features and treatment strategies is important in order to correctly manage these patients.
This article focuses on the clinical presentation of renal stone disease and the clinical management of these patients. It also aims to create a stepwise sequence of scenarios, similar to how a foundation trainee would encounter a patient with renal stones.
Acute kidney injury (AKI) can be defined as an abrupt decrease in urine output and/or an increase in serum creatinine. It frequently occurs as a result of systemic illness or may represent intrinsic kidney disease. This article discusses the principles behind the evaluation and initial management of patients with AKI. The aims of the article are to promote awareness of the importance of early recognition of AKI, to discuss fluid management, and to revise common causes of AKI in hospitals.
Improvements in technology and availability of imaging have contributed to significantly increased utilization of radiological techniques in the patient diagnostic pathway. This article concentrates on the role of imaging in the assessment and diagnosis of patients who present with symptoms or signs related to the kidneys, a common scenario in foundation practice. Imaging strategies are presented in relation to differing clinical presentations, with discussion of the relative strengths and weaknesses of individual modalities.
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