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Kaplan Qbank USMLE



Author15 Posts
  #1

2 most common scenario in which BUN is elevated but the creatinine level is normal - it's an important concept I guess :
List them :
1.
2.
smiling face

  #2

1. GI bleed

2. pre renal azotemia

?


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  #3

study_ing - GI bleed is correct but explain why do you think 2. choice is pre renal azotemia raised eyebrow

  #4

and also write all the labs for prerenal azotemia....please don't get confused !

  #5

i think, creatinine has to be increased in prerenal azotemia...it might be a slight increase but it can not be normal .
please correct me if i am wrong .

  #6

hmm increased protein intake..

sorry i mixed up the ratio with the absolute level.


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If you yourself are at peace, then there is at least some peace in the world.

  #7

The second common scenario where you can see increased BUN without increased creatinine level is the administration of steroids

  #8

Now tell me in what scenario you would find an Increase in Creatinine without an increase in BUN -- that is also important wink

  #9

increased muscle mass


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If you yourself are at peace, then there is at least some peace in the world.

  #10

hmm, but are you sure that increase in muscle mass doesn't effect Urea levels at all....because i don't know about this

  #11

what I know is that an isolated increase in Creatinine with normal BUN is a result of some medications like bactrim (Trimethoprim-sulp.), cimitidine etc., which inhibit the secretion of creatinine from renal tubular cells .

  #12

thanx..will let u know if i find out for sure..

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  #13

thanx smiling face

  #14

urea (with normal creatinine) is also increased in dehydrated patients (common finding i think)


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  #15

Mars-Aris wrote:
urea (with normal creatinine) is also increased in dehydrated patients (common finding i think)



In dehydration both urea and creatinine shoud go "up".

Dehydration -----------> decreased GFR -----------> decreased creatinin clearance ---------> increased plasma creatinin level

Best of luck








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