sandra
Forum Guru
Topics: 180
Posts: 426
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A 62-year-old woman comes to the physician because of generalized weakness for 2 weeks. She
has a 20-year history of arthritis of the hands treated with aspirin and acetaminophen. She had two
episodes of urinary tract infections 5 and 11 years ago, respectively. Examination shows no
abnormalities except for Heberden's nodes on the hands. Laboratory studies show:
Erythrocyte sedimentation rate
15 mm/h
Serum
Na+
136 mEq/L
Cl–
100 mEq/L
K+
4.9 mEq/L
HCO3–
20 mEq/L
Urea nitrogen (BUN)
41 mg/dL
Creatinine
4 mg/dL
Urine
Protein
1+
WBC
2–4/hpf
RBC
none
Bacteria
none
Squamous epithelial cells
occasional
Granular casts
occasional
Renal ultrasonography shows no abnormalities. Which of the following is most likely to have
prevented this condition?
A
) Periodic PPD skin testing
B
) Screening for autoimmune causes of glomerulonephritis
C
) Periodic renal ultrasonography
D
) Avoidance of analgesics
E
) Suppressive antibiotic therapy for treatment of urinary tract infections
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| docnikki
Forum Guru
Topics: 93
Posts: 680
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it looks like analgesic nephropathy..so AD.
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