09-29-2014, 07:50 PM
ATN?
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@sarahmle - cardio69
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09-30-2014, 07:42 AM
AAA. Looks like she has a ureteric colic to me but since the option is not there, the next one that makes sense (i mean, that could explain the excruciating flank and groin pain) is renal vein thrombosis.
09-30-2014, 11:09 AM
Renal papillary necrosis RPN (@crush are u clear now ? I think so)
Endpoint of various *dz . Here you have pat diabetic automatically as you voice of Goli should come to mind sugar coating/glucosuria DM of arteries and predisposes pat acute pyelonephritics safe home for bugs to grow in rich medium environment -> urinary colic, flank & severe groin PAIN. PAY attn. what been given, other choices not match complication of PYELONEPHRITIS $ You can remember it “POSTCARDS” and add it to yr FA. Pyelonephritis $ Obstruction ( more in adult males) SC dz Tuberculosis Cirrhosis Analgesics (affects middle aged F more than M) Renal vein thrombosis Diabetes (MC) Systemic vasculitis Papillae & Medulla vulnerable to ischemic necrosis WHY? LACK/def of O2 and make in state of slow motions flow -> supply vasa recta in top of the hypErtonic environment -> reduce BF-> Frank ischemic necrosis. They would not always give all MC signs & symp that you think must be there to make dx Flank pain/Dysuria/HTN/Pyuria/Hematuria/ acute oliguric RF for any steps. Pay attention what pat comes with HTN/DM/and many chronic dz come into scenario that Steps hit on preventive med.
09-30-2014, 11:15 AM
thanq cardio.. i thot RPN was RPGN
 ( i took tubular necrosis (
09-30-2014, 12:08 PM
@sarah no worry as long as u make mistake here u are fine. Try to take them Qs like real exam 72sec and cast your vote as help sweety on her exam by practicing time window.
_________________________________________________________________________________ @sarah lets try, read it and pick. A 86 y/o F with dementia admitted to hospital from nursing home with difficulty breathing & cough. On ad, temp 39.1/102.4, BP 95/60, pulse 110/min. RR 24/min, SO2 93% on room air. She has dry mucous membrane, deep furrows in her tongue, JVP are not visible @30 deg. She alos has crackles at her R lung base. lab Cr 0.6 mg/dL Urea nitrogen 25 mg/dL Hb 13.5 g/dL Leukocytes 18000 w L shift Platelets 356000 X-ray consistent w pneumonia she is given levofloxacin. Over next few days here MAP stay 70s & here Cr inc 4.5 mg/dL. Urine Na 50 mEq/L. The urine is pun & exam. Most likely finding? a)White cells cast b)Red cells, numerous, without cast c)Red cells casts d)Granular epithelial cell casts “ muddy brown” e)Eosinophils
09-30-2014, 01:16 PM
ATN >> MUDDY BROWN >>> DUE SEPTIC SHOCK LEAD TO PERSISTENCE HYPOTENSION >> PRE RENAL END BY RENAL ( NA MORE THAN 40) , 1ST PART OF PCT WILL BE LOST IN THE URINE
09-30-2014, 05:02 PM
yes cardio. i'm clear abt that concept now.
ans for this q = D |
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