Case Series: Unnanounced UDS Induced Anuria.

[101N]

Hard to splain how a healthy young adult becomes anuric for 2hrs inspite of copious waiting room fluid resuscitation. Have I discovered a new disease?

---

Members don't see this ad.

 

[lobelsteve]

illicit oliguria.

 

[emd123]

Hard to splain how a healthy young adult becomes anuric for 2hrs inspite of copious waiting room fluid resuscitation. Have I discovered a new disease?

Yes you have! I thought I was the first one to see this "zebra!" It's a devastating and untreatable condition unless the antidote is stuck directly under the tongue immediately. The only antidote known in the modern world for this sudden onset and mysterious disease is the saliva drug screen sublingual probe. Usually this causes an immediate and amazing reversal of all symptoms and induces superhuman strength, similar to an amp of narcan IV. Invariably, this induces the previously indolent patient to set a personal record in the 40 yard dash running out the office door. Oh, how wondrous the world of Medicine is...

 

[Jcm800]

it must be infectious… we have tons of it in Indiana. because i have never met a such a bug that has such a predisposition to medicaid and joblessness...

 

[Jcm800]

Hard to splain how a healthy young adult becomes anuric for 2hrs inspite of copious waiting room fluid resuscitation. Have I discovered a new disease?

this is why we used to have all questionable patients come in for 8am appointments… number one they don't show up that early, and number two… you can let them sit there all day if you choose, waiting for the pee. "I just went"

i just went also, but could go again, in 5 minute intervals to give SOME urine...

 

[101N]

this is why we used to have all questionable patients come in for 8am appointments… number one they don't show up that early, and number two… you can let them sit there all day if you choose, waiting for the pee. "I just went"

i just went also, but could go again, in 5 minute intervals to give SOME urine...

In a healthy young adult 800mL/24hr is a low average. That's 33mL/hr. My UDS POC requires only 30mL.

When they insist on playing the game I insist on a serum draw, it's in my tx agreement.

 

[Aether2000]

We tried blood analysis on 20 or so patients before saliva testing became available. The results were very erratic with the rapidly redistributed or cleared opioids sometimes not showing up at all. Of course saliva testing is useless in certain situations (for instance cannot pick up fentanyl in most cases), but it is the best thing outside of urine tox quantitative studies.

 

[Ducttape]

We tried blood analysis on 20 or so patients before saliva testing became available. The results were very erratic with the rapidly redistributed or cleared opioids sometimes not showing up at all. Of course saliva testing is useless in certain situations (for instance cannot pick up fentanyl in most cases), but it is the best thing outside of urine tox quantitative studies.

Blood testing is not reliable enough to use on a regular basis. i dont bother.

the "treatment du jour" towards this form of oliguria is to quote the Soup Nazi - "no (drugs) for you".

 

[clubdeac]

I found a pretty good antidote, we now stock a sterile cath in the office. Had to do this after a problem patient, 29 y/o WM with bipolar d/o and h/o substance abuse claimed anuria based on chronic prostatitis. We told him we were going to cath him and voila... he can pee

 

[ampaphb]

cheek swab now, or come back tomorrow for uds. no controlled meds till results available

 

[Jcm800]

cheek swab now, or come back tomorrow for uds. no controlled meds till results available

come back tomorrow? what?

 

[101N]

Back i

come back tomorrow? what?

Dude: move to Oregon. We got the same philosophy.