doc649
Topics: 19
Posts: 64
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A 37-year-old man presents to the ED complaining
of swelling of his legs, hands, and face
for 4 days. On examination he is afebrile with
generalized edema of his upper and lower extremities
as well as his face. His examination is
otherwise notable only for scars in a linear pattern
on his middle to lower arms bilaterally.
Basic metabolic panel and complete blood
cell count are normal, but liver function tests
show total protein of 5.4 mg/dL and albumin
of 2.8 mg/dL. Urinalysis shows 3+ protein
without significant red or white blood cells.
What is the most likely etiology of this patient’s
disease?
(A) Antibody deposition
(B) Cardiomyopathy
(C) Cocaine abuse
(D) Heroin abuse
(E) Hyperglycemia
(F) Streptococcal infection
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| Eagle_303
Forum Guru
Topics: 77
Posts: 655
|
Heroin abuse : FGS = focal glomerular sclerosis
Other causes are :
- HIV
- Ablation nephropathy
- Obstructive nephropathy
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| dr.wad
Forum Senior
Topics: 3
Posts: 350
|
D - heroin
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| yarab99
Forum Elite
Topics: 23
Posts: 414
|
D-heroin abuse
Nephrotic /Focal Segmental glomerulopathy,,,the tracing scars in the arm suggest heroin
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| brutus25
Forum Junior
Topics: 13
Posts: 62
|
I may be wrong but I thought FSG is Nephritic in origin
In my opinion we are dealing with a Nephrotic sdr based on the urinary protein ( 3+ )
Maybe he introduced a Strep with one of his needles --> Streptococcal infection
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| Markus2009
Forum Senior
Topics: 9
Posts: 191
|
Heroin --------->Focal glomerular sclerosis
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| doc649
Topics: 19
Posts: 64
|
The correct answer is D. This patient presents
with generalized edema, hypoalbuminemia,
and marked proteinuria, findings strongly
suggestive of a nephrotic syndrome. The track
marks on his arms are highly suggestive of drug
abuse. Putting this picture together, one can
deduce that the patient has focal segmental
glomerulosclerosis (FSG), a nonspecific nephrotic
syndrome that may be secondary to
heroin abuse. Other causes of secondary FSG
include lithium and malignancy, particularly
lymphoma.
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