On Thursday Dr Schneider presented an unusual case of anemia with both macrocytic and hemolytic features. It sounded suspiciously like this case.
Blood smears are an indispensable tool in evaluating obscure anemias. The article I mentioned is a comprehensive review with great pics and is linked here: N Engl J Med 2005; 353:498-507 August 4, 2005
Frida y's "mystery case" was severe symptomatic hyponatremia pecipitated by excessive intranasal ddavp usage in a pt with DI. I have found this article very helpful for learning/teaching about the workup of hyponatremia: CMAJ February 3, 2004 vol. 170 no. 3
The article walks through the workups of different causes and offers some pointers for correction rates with hypertonic saline. Just remember that normal saline will worsen SIADH.
Also be aware of the risk of central pontine myelinolysis with too rapid correction.
Review of topics covered in morning report, M&m, and core conferences with links to supplemental reading material.
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