DrVirgo
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116. A patient with previously normal renal function (BUN 10mg/dL, plasma creatinine 1.0 mg/dL, and creatinine clearance 120mL/min) is admitted to the hospital with severe dyspnea and is diagnosed with congestive heart failure. On admission, creatinine clearance is 80 mL/min, and a 24-hour urine collection contains 750 mL. The BUN and plasma creatinine would most likely be which of the following?
Plasma Creatinine BUN
(mg/dL) (mg/dL)
A. 1.0 15
B. 1.5 35
C. 2.0 10
D. 4.0 40
E. 5.0 20
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| mitty
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B?
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| DrVirgo
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Yes, its B
Can you explain?
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| robin082006
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B
prerenal failure, BUN/Cre>15
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| DrVirgo
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Right.
Prerenal azotemia due to heart failure.
BUN increases disproprotionately due to reab. in PT.
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| leen
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I wonder why not D then??
thanks
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| DrVirgo
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D is a proportional increase. 10/1 ratio still.
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| docarchana
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why not A? bcos acc to qbank, in prerenal azotemia, BUN increase but creatinin is normal.
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| new_n_lost
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but if its heart Failure the 24 hr urine output suggests that the PRE Renal shifted into Renal Azotemia the ratio essentially remains the same but the rise in both the contents of Creatinine n BUN (GOLJAN)
so in my choice the answer wud be D cos the urine collections is still 750 ml even though it started off pretty good that is 80 ml /min
plz give me ur input guys wud really appreciate it
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| docsrinu
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acc to goljan, in both pre & post renal azotemia BUN/C >15.
in renal azotemia, both BUN & C increase proportionately and ratio remains 10/1.
so wats the ans now? this q appears to be too difficult.
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