sfk
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A demented elderly man is transferred from a nursing home to the emergency department because of generalized edema. patient is afebrile, blood pressure normal. serum creatinine of 2.0 mg/dL and serum urea nitrogen of 65 mg/dL.
Which of the following is the most likely diagnosis?
A. Acute tubular necrosis
B. Congestive heart failure
C. Low protein intake
D. Prostatic hyperplasia
E. Severe liver disease
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| drhouse
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B
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| new_n_lost
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tricky one
Ans is D
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| SILVER
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D. Prostatic hyperplasia
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| drhouse
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why D.
is it initial stage of post renal azotemia.
and why not B????
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| new_n_lost
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BP is Normal Major Indication tht this is not CHF
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| SmokyWaters
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yes its D.....
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| sfk
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yes, the answer is D. i didnt get the explanationvery well, here it is:-
This patient with oliguria and edema has high serum creatinine (normal 0.6-1.2 mg/dL) and high serum urea nitrogen (normal 7-18 mg/dL). The serum urea nitrogen/serum creatinine ratio is 32, greater than the normal. High ratios with elevated creatinine levels can occur in postrenal obstruction (probably benign prostatic hyperplasia in this elderly man) and in prerenal azotemia that is superimposed on renal disease (but not pure prerenal azotemia, as would occur in simple congestive heart failure). The reason for the high ratio is that urine flow obstruction causes back pressure on the renal tubules, favoring back diffusion of urea into the blood from the tubules.
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| drduck
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ratio BUN to creat > 10, has to be post renal.....obstruction...
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