ganesha123
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A 5-year-old boy is brought to the physician 1 hour after
urinating bright red blood. He has been taking ibuprofen since injuring his
right flank while wrestling with friends yesterday; he also has been
taking penicillin for 3 days for streptococcal pharyngitis. His
temperature is 36.7 C (98 F), blood pressure is 90/48mm Hg, pulse is 108/min,
and respirations are 18/min. Examination shows purple ecchymoses over
the shins and right flank; there is tenderness of the right
costovertebral area. The abdomen is nontender. Genital examination shows no
abnormalities. There is no edema. Urinalysis shows gross blood;
microscopic examination shows 5–10 leukocytes/hpf and erythrocytes that
are too numerous to count. Which of the following is the most likely
explanation for this patient's hematuria?
A) Acute pyelonephritis
B) Ibuprofen-induced acute papillary necrosis
C) Post-streptococcal glomerulonephritis
D) Rhabdomyolysis
E) Traumatic injury to the kidney
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| peter90036
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nice one
E
ugh
B? --- because is acute pap necrosis whole blood?and no casts? *possible because of the hypotension ...imma go check
damn...
not A, not C, ...not D
Edited by peter90036 on 03/21/08 - 02:43 PM
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| ganesha123
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yeah i was torn between b and e too..!!!!!
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| peter90036
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http://www.springerlink.com/content/p7qlg5m0pt2hn...
... 
but id still pick trauma 
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| ganesha123
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thanks.. yeah i guess B is the answer.. tho i ended up picking trauma in the actual exam too..!!!!!!
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| liliaeliz
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it is e , because is too ealy for b
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| Jcala
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E
Normal BP for his age
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| aspire
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E-Traumatic injury tokidney.
Right answer?
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