Urinary Disorders

  1. A 6-year old boy is diagnosed with acute glomerulonephritis that developed after a streptococcal throat infection. At this time, the following manifestations are noted: decrease in urine output, increasing lethargy, hyperventilation, and generalized edema. Trace amounts of protein are detected in his urine. Blood analysis reveals the following: pH = 7.35; HCO3 = 18 mEq/L; hematocrit = 29%; Na = 132 mEq/L; K = 5.6 mEq/L; blood urea nitrogen (BUN) = 62 mEq/dL; creatinine = 4.1 mg/dL; and albumin = 2 g/dL.
    A. What is the probable cause of this boy’s glomerular disease?
    B. Which laboratory values are abnormal? What is the significance of each abnormal value?
    C. Is he progressing to uremia? How can you tell?
  2. A 26-year-old woman makes an appointment with her healthcare provider complaining of urinary frequency, urgency, and burning. She reports that her urine is cloudy and smells abnormal. A urine dipstick indicates the presence of infection; a urine sample is obtained for culture and she is given a prescription for antibiotics.
    A. What microorganism is likely responsible for this infection?
    B. What factors may have predisposed her to this infection?
    C. What could she do to prevent future infection?
    Fluid, Electrolytes, & Acid-Base Balance
  3. A 70-year-old woman who is taking furosemide (a loop diuretic) for congestive heart failure complains of weakness, fatigue, and cramping of the muscles in her legs. Her serum potassium is 2.0 mEq/L and her serum sodium is 140 mEq/L. She also complains that she sometimes notices a “strange heartbeat”.
    a. What is likely causing this woman’s symptoms?
    b. An ECG shows a depressed ST segment and low T wave changes. Explain the physiologic mechanism underlying these changes.
  4. A 16-year-old girl is seen by her primary care doctor because her parents are concerned about her binge eating and their recent discovery that she engages in self-induced vomiting. Initial laboratory tests reveal a serum K+ of 3.0mEq/L and Cl- of 93.
    a. Explain the mechanism behind her low K+ and Cl- .
    b. What type of acid-base abnormality would you expect her to have?

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