alice8
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A 23 year old Caucasian lady was hospitalized for colicky pain in her back and lower abdomen and nausea for two days. She was hospitalized three weeks previously for similar complaints. While hospitalized she passed six small stones in her urine. An intravenous pyelogram showed multiple calculi in both renal pelvices, but neither hydronephrosis nor bladder stones. Her past medical history included pancreatic insufficiency, insulin dependent diabetes and recurrent pulmonary infections. She was tachycardic, afebrile and mildly dehydrated with mild hypogastric tenderness and bilateral course inspiratory and expiratory crackles. Her 24 hour urinary excretion of oxalate was 4.2 mmol. Her hospital course was complicated by emphysematous cystitis that responded to the antibiotics. With hydration and pain medications her symptoms gradually subsided.
If she has a diognosis of Cystic Fibrosis ,than patients which condition is unrelated with her CF disease
A)Renal stones
B)Pancreatic insufficency
C)IDDM
D)Recurrent pulmaonary infections
E)All of them are related with CF
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| zaki
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A. renal stones
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Maverick
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| alice8
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Correct answer is E )all of them are related with CF
Patients with CF have associated hyperoxalouria, hypercalciuria, hyperuricosuria, increased urinary saturation of calcium oxalate, and are at high risk for developing renal calculi . Ninety two percent of CF patients have medullary nephrocalcinosis at necropsy. In a series of 140 patients with CF the incidence of renal stones was 5.7 % and crystalluria 4.2% . In a telephonic survey of 201 CF patients 15 years of age and older 5.5% had documented nephrolithiasis and 4% had two or more episodes of urolithiasis.
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| carla
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Dear Alice8
How come the question is: which condition is unrelated with her CF disease and your answer is E? Could you explain....I maybe confused :oops:
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Carla
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| alice8
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Pancreatic insufficiency and fatty acid malabsorption in patients with cystic fibrosis creates an excess of fatty acids that bind calcium in the gut and increases hyperoxaluria. The colonic microflora Oxalobactor formigenes regulates both the absorption of oxalic acid through the intestine and the plasma concentration of oxalic acid. Frequent use of oral antibacterial agents in these patients decolonizes the colon thereby reducing the anaerobic degradation of oxalate and aggravates hyperoxaluria ...Ninety two percent of CF patients have medullary nephrocalcinosis at necropsy...
So other than our classical knowledge about CF (answers b,c,d) a)renal stones are also very common in people with CF
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