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cirus
Forum Guru  Topics: 99 Posts: 736 |
A 5-month-old male infant has a urine output of less than 0.1 mL/kg/hr shortly after undergoing major surgery. On examination, he has generalized edema. His blood pressure is 94/48 mm Hg, pulse is 140/min, and respirations are 20/min. His blood urea nitrogen is 38 mg/dL, and serum creatinine is 1.4 mg/dL. Initial urinalysis shows a specific gravity of 1.018 and 2+ protein. Microscopic examination of the urine sample reveals 1 WBC per high-power field (HPF), 18 RBCs per HPF, and 5 granular casts per HPF. His fractional excretion of sodium is 3.2 %. Which of the following is the most appropriate next step in diagnosis? A. CT of the abdomen and pelvis B. Cystourethrography C. Intravenous pyelography D. Renal biopsy E. Renal ultrasonography
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Justice
| class of 2012  Topics: 140 Posts: 3096
C. Intravenous pyelography - to assess the renal glomerulal blood flow and filtration
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kingsofke
| Forum Guru Topics: 25 Posts: 716
A. CT of the abdomen and pelvis
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cirus
| Forum Guru Topics: 99 Posts: 736
The ans E.renal ultrasound(from kaplan qbank) but the explanation wasn't there..does anyone know why??
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kavi
| Forum Newbie Topics: 4 Posts: 18
this kid has low urine output, elevated BUN and fractional excretion on sodium >1 points towards ARF. And seeing this had happened following major surgery would suspect some obstruction and hence evaluate for dilation with renal U/S. Cant do IVP as he has poor renal function.
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virgola82
| Forum Junior  Topics: 89 Posts: 364
He should have ATN following surgery so I think U/S (option E) could detect it, am not sure though...
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