Path kidneys ( yummy)

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Path kidneys ( yummy)

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mytime
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04/05/07 - 11:20 AM

A 60 year old hospitalised being traeted with Gentamicin, long-term i/v, suddenly becomes nauseous and oliguric. Physical exam shows development of rales and new arrhythmia. ECG shows, peaked T-waves with prolonged QT segment. Lab values show hyperkalemia, hyperphosphatemia, azotemia.and elevated urine sodium. Urine sample shows muddy brown casts. What would be the wrong with his kidneys

A) Chronic pyelonephritis

B) Goodpasture's Syndrome

C) Ig A nephropathy

D) Rapid Progressive Glomerulonephritis

E) Acute tubular necrosis

me007
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04/05/07 - 11:25 AM

rock
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04/05/07 - 11:29 AM

focusmle
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04/05/07 - 11:34 AM

E) Acute Tubular Necrosis.

keepgoing
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04/05/07 - 11:38 AM

nephrotoxic ATN -->e

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new_n_lost
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04/05/07 - 12:02 PM

E) Acute tubular necrosis Has all the Classical Signs of ATN

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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."

mytime
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Topics: 39
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04/05/07 - 12:11 PM

GOOD JOB all!

I should have made the vignette tougher, I guess!

Will post more about same here!

mytime
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04/05/07 - 12:30 PM

ACUTE TUBULAR NECROSIS (Mcc of ARF)

Etiology

1. Renal Ischemia (prolonged HTn, shock)

2. Crush injury (intense exercise, myoglobinuria)

3. Nephrotoxic drugs ( aminoglycosides)

Pathology - kidneys

1.Focal tubular epithelial necrosis

2. rupture of basement membrane

3. Eosinophilic hyaline casts in collecting ducts

4. Intestitial edema

5. Evidence of epithelial regeneration (flattened cells with mitotic figures)

C/P ARF.

Death due to high K+ induced arrhythmia.

Lab- oliguria ,U.NA+ >40 ; tubular epth cell casts (muddy-brown casts)

hyperkalemia

Rx Loop diuretics, electrolytes and fluid. Dialysis

Edited by new_n_lost on 04/05/07 - 12:55 PM

drmohamed811
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04/14/07 - 07:37 AM

acute tubular necrosis is the answer

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