Question

A 30-year-old man male arrives at the emergency room with shortness of breath, malaise, and nausea. History reveals that he had pharyngitis two weeks ago, but his throat does not bother him anymore. He did not see a doctor at that time

Physical examination: bilateral crackles over both lungs, bilateral edema of the feet.

Pulse: 82             body temp: 37 c          respirations: 18/min      B/P: 120/85 mmHg

Blood Tests:

pH: 7.32      Albumin/ blood: 2.2g/L     hematocrit: 35.4%

WBC : 12.900/mm    BUN : 51 mg/Dl    bicarbonate : 14 mEq/L

Urinalysis :

Ph :6    protein: 500mg/dl    specific gravity: 1.036 glucose: negative   ketones: negative

Color, clarity: clear

Questions

1. What abnormalities found in the urine?
2. What is likely causing edema? Discuss anatomy and physiology
3. What is likely causing shortness of breath?
4. Why is the hematocrit low?
5. Can you determine a likely diagnosis that explains all this patient findings? Why you came to that conclusion

Answer 1

1.Protein is present in the urine which is an abnormality because normally the proteins are not present in the urine.

2.Due to proteinuria protein is lost in urine.This leads to decrease in the blood albumin level.Ablumin is involved in the collidal osmotic pressure and low albumin results in accumulation of fluids resulting in edema.

3.Hematocrit value is low because of anemia

The diagnosis is poststreptococcal glomerulonephritis.Pharyngitis first occured in throat due to streptococcus which later infected glomerulus resulting in inflammation and loss of protein