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WHAT'S THE DIAGNOSIS?? (NBME)
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Author7 Posts
  #1

A 5-year-old boy is brought to the emergency department 30 minutes after he fainted at home after standing up from a sitting position. His symptoms began 3 days ago with diarrhea and vomiting. He has had no urine output for 18 hours. He is alert but quiet. His temperature is 37.5 C (99.5 F), blood pressure is 75/45 mm Hg, pulse is 120/min, and respirations are 28/min. Examination shows dry lips and tenting of the skin. There is no abdominal tenderness. Bowel sounds are hyperactive. The remainder of the examination shows no abnormalities. His capillary refill time is 5 seconds. Intravenous bolus doses of 0.9% saline are administered. Bladder catheterization yields 5 mL of urine. Urinalysis is most likely to show which of the following?

A
) Blood

B
) Erythrocyte casts

C
) Hyaline casts

D
) Leukocyte casts

E
) Oxalate crystals


  #2

HUS ? raised eyebrow

  #3

DIARRHEA VOMITING.......HYPOVOLEMIC...... ANSWER C

  #4

DX ACUTE RENAL FAILURE(DESHIDRATATION)

  #5

Ans D


  #6

Choice: C

pt shows signs of dehydration secondary to vomiting and diarrhea, hence...hyalin casts are see in UA.


___________________
"Our greatest glory is not in never falling but in rising every time we fall." --Confucius

  #7

Given answer is C







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