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70 YEARS OLD AFRICAN AMERICAN MAN CAME TO ED WITH ACUTE ONSET OF ANURIA ,NAUSEA,VOMITTING AND MALAISE.RECENT MEDICAL HISTORY IS REMARKABLE FOR IVP PERFORMED 2 WEEKS AGO AND TREATMENT WITH TCA STARTED 1 WEEK AGO.INSERTION OF FOLEY'S CATHETER YIELDS 700 ML OF CONCENTRATED URINE.LABORATORY STUDIES SHOW HIGH URINE OSMOLALITY AND LOW URINE SODIUM.WHAT WOULD BE THE CAUSE OF PATIENT CONDITION ?
A. RADIOGRAPHIC CONTRAST TOXICITY
B. UNILATERAL URETRAL STONE
C. BPH
D. SICKLE CELL DISEASE
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ccc is the correct answer
bcoz patient has normal urine production but due to post renal obstruction pt came as a acute retention.
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does the TCA aggravated his BPH symptoms as it has alpha blocking effect
and the urine c high osmol but urine Na low is there any substance contributing to the high urine osmol. ?? urea??? is there contrast toxicity effect & the urine collected through the foley catheter may not indicate the recent renal status (previous collectio)unless after this , 24 hr urine collection made & indicate good output??
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tca has anti cholinergic effect lead to urinary retention
