Prep for USMLEPrep for USMLE Forum
   Forum    Step 1  Step 2 CK Step 2 CS Step 3  Match  IMGs Resources Search




Prep4USMLE Forum » USMLE Step 2 CK Forum » Internal Medicine Forum



Previous Topic | Next Topic  Renal failure in HTA and DM ! 


Login or Register to post messages 




Rated:
  • 0/5
  • 1
  • 2
  • 3
  • 4
  • 5
(0 votes)
Author11 Posts
doc_clotaire
Forum Guru
avatar

Topics: 159
Posts: 1,301
04/19/07 - 02:07 PM       #1

A 60 yo woman comes to the physician because of 3 month history of worsening fatigue and back pain . She has had diabetes melillus for the past 3 year and hypertension for the past 10 years .

Laboratory shows :

Hb : 9 mg/dl

Serum Ca : 9 mg/dl

Serum Phosphurus : 3.5 mg/dl

BUN : 30 mg/dl

Serum Creatinine : 2.0 mg/dl

Which of the following is the most likely cause of her renal failure ?

a ) Hypertension

b ) Diabetes Mellitus

c ) Paraprotein

d ) Primary hyperparathyroidism




___________________
The elevator to succes is broke ,you must take the stairs

vradojc1
Forum Elite
avatar

Topics: 21
Posts: 309
04/19/07 - 02:11 PM       #2

b

sprint123
Forum Guru

Topics: 129
Posts: 870
04/19/07 - 02:39 PM       #3

I am thinking of Hypertension since HT is more common cause for renal failure than DM

Adam
Forum Senior
avatar

Topics: 6
Posts: 136
04/19/07 - 03:03 PM       #4

DM usually doesn't cause renal failure within 3 years, It needs at least 5-10 years ,, so I think of Hypertension (A)

___________________
I will not say I failed 1000 times.. I will say that I discovered there are 1000 ways that can cause failure ..

Justice
Just signed contract
avatar

Topics: 118
Posts: 2,369
04/19/07 - 03:19 PM       #5

I guess DM just worsened HTN-nephropathy

(A)



___________________
The winner takes it all...

vradojc1
Forum Elite
avatar

Topics: 21
Posts: 309
04/19/07 - 05:18 PM       #6

At the time of diagnosis of type 2 DM the disease has usually been present for some time. And the most common cause of CRF is DM. However, I skipped over the time span and would correct my answer to HTN.
DM 30% RF
HTN 25% RF
(Kaplan data)

Justice
Just signed contract
avatar

Topics: 118
Posts: 2,369
04/19/07 - 05:26 PM       #7

I have also been thinking over this Q... Yes, DM is a more frequent cause of renal failure... HTN preceded DM, but DM-RF could develop faster than usually if there were some organic changes in renal vasculare due to HTN... One would say that this is a DM-RF, and would be, I think, correct...
doc_clotaire, do you have the right answer?
Thanks...

___________________
The winner takes it all...

dr.wad
Forum Senior
avatar

Topics: 3
Posts: 350
04/19/07 - 06:14 PM       #8

( C ) >>>paraprotein ( multiple myeloma )>>>>back pain , anemia , renal failure.

Justice
Just signed contract
avatar

Topics: 118
Posts: 2,369
04/19/07 - 07:07 PM       #9

dr.wad wrote:
( C ) >>>paraprotein ( multiple myeloma )>>>>back pain , anemia , renal failure.

Under these conditions Ca MUST be high, but we have classical renal hypo-Ca hyper-phosphatemia... No, this is not MM

___________________
The winner takes it all...

dr.wad
Forum Senior
avatar

Topics: 3
Posts: 350
04/20/07 - 01:57 AM       #10

indeed i am sorry , i dont know how i read Ca as being high .

so in this case i will go with ( A ) hypertensin for the same cause given by Adam.

doc_clotaire
Forum Guru
avatar

Topics: 159
Posts: 1,301
04/20/07 - 02:19 PM       #11

A for all of you nod

___________________
The elevator to succes is broke ,you must take the stairs









Login or Register to post messages






show Similar forum topics

HIV and Renal failure--------q
renal failure
Renal Failure
Chronic Renal Failure and PTH
show Related resources

Renal Physiology Tutorial












Contact us | Terms & Conditions | Privacy Policy

Copyright @ Prep for USMLE. All rights reserved.