doc4mindia
Forum Guru
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68-year-old white male who lives alone is admitted after having been found by his daughter lying on the basement floor. No one knows for sure how long he had been lying there. He seems confused and is noted to have a tri-malleolar fracture of the right ankle. His only prior medication was ibuprofen, 800 mg 3 times a day which he took for a "sore shoulder."
After admission, you note that he is oliguric with a 24-hour urine output of 320 cc. His blood urea nitrogen (BUN) is 65 mg/dL and serum creatinine is 2.1 mg/dL. On a physical examination which he had only 2 weeks prior to admission, a chemistry profile had noted the BUN as 14 mg/dL and the creatinine as 1.1 mg/dL. Urinalysis shows 1+ protein, occasional white cells, no red cells, and no cellular casts. Urine osmolality is 618, urine sodium is 3 mEq/L, and urine creatinine is 105 mg/dL.
The most likely cause of his oliguria is
acute tubular necrosis
decreased renal perfusion
acute glomerulonephritis
renal toxicity of ibuprofen
bilateral cortical necrosis
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| dimps
Forum Guru
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Posts: 446
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decreased renal perfusion
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hi how r u
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