“A 54 y.o. M who works in a dry cleaner presented to the hostpial three days ago with fever and shaking chills of one day’s duration. He notes a history of nocturia, heistancy, and poor stream for the past three months.” Blah blah blah, it turns out this guy has pyelonephritis, obstructive uropathy secondary to BPH, and acute tubular necrosis from the aminoglycosides he was given for the pyelo. Tough luck.
Usually when they give us these scenarios they try to give us clues, like the fact that he worked in a dry cleaner. But this is our kidney block not our liver block, and there was no connection between the disease and environmental toxins. ANYHOW, it lead my professor toward a teaching tangent…
In the olden days felt hats were cleaned with mercury. Those that wore the hats after they were cleaned became deranged from the Mercury and thus we get the phrase, “mad as a hatter.”
You learn something new every day.