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Contributor score: 6
I think the distribution half-life and elimination half-life was saying that by the time you checked, it had fully distributed (10 half-lifes) and had not been cleared yet (super long half-life)
1000ug= 1mg and 1g=1000000ug
so then 4ug/ml * 1g/ 1000000ug= 0.000004 g/ml
0.000004g/ml * 1000ml/L= 0.004 g/L
80mg*1g/1000mg= 0.08 g
vd= 0.08g/ 0.04g/l =20L
alcoholic in the hx should point you towards avascular necrosis when there is an “atraumatic” complaint
this kid has chronic pyelonephritis due to recurrent UTIs (VUR/hydronephrosis is a risk factor). And -itis = inflammation. That was my take on it.