I had a similar thing happen to me when a particularly insane pediatrics attending told me to consult nephro for a kid who was having some viral myositis because she was sure he was having rhabdomyolysis despite the fact he was putting out 150 cc of urine an hour and had a CK of about 2000 (her logic being that since he'd had the myositis before, it must be a chronic thing....or something like that. No one on our team was really sure what she was doing).
My personal favourite was having to consult neurology on a man with newly detected brain metastases - for workup of his gait instability. You know, because the multiple masses in his brain weren't enough reason for him to have difficulty walking.
Testing for porphyria: Go take some pee in the UV light.
My grandfather went through 3 months in hospital, seizures (from the medication), unnecessary appendectomy, a cardiac arrest... before someone accidentally put his urine under UV light, and noticed that it turned brown. He was then diagnosed with porphyria.
Your attending would have made a diagnosis occur much faster with him!
However, if I was working in GI, I would also be laughing at you!
Yeah, porphyria is also used to torture neurology residents.
ReplyDeleteI've come to suspect that porphyria is actually a made up disease, used only for pimping students and episodes of House.
ReplyDeleteYou should have asked him what KIND of porphyria.
ReplyDeleteI had a similar thing happen to me when a particularly insane pediatrics attending told me to consult nephro for a kid who was having some viral myositis because she was sure he was having rhabdomyolysis despite the fact he was putting out 150 cc of urine an hour and had a CK of about 2000 (her logic being that since he'd had the myositis before, it must be a chronic thing....or something like that. No one on our team was really sure what she was doing).
ReplyDeleteNeedless to say I got a similar reaction.
My personal favourite was having to consult neurology on a man with newly detected brain metastases - for workup of his gait instability. You know, because the multiple masses in his brain weren't enough reason for him to have difficulty walking.
ReplyDeleteTesting for porphyria: Go take some pee in the UV light.
ReplyDeleteMy grandfather went through 3 months in hospital, seizures (from the medication), unnecessary appendectomy, a cardiac arrest... before someone accidentally put his urine under UV light, and noticed that it turned brown. He was then diagnosed with porphyria.
Your attending would have made a diagnosis occur much faster with him!
However, if I was working in GI, I would also be laughing at you!
Porphyria is common in pet rats.
ReplyDelete/the more you know
Cattle with porphyria have teeth that glow pink under UV light!
ReplyDelete/the more more you know
It's believed that King George III most likely had porphyria, which was responsible for his well-documented mental illness...
ReplyDelete/the more you know