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Old 08-03-2011
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Kidney Abnormal renal disease in lethargic man

A 72-year-old man has been feeling tired and lethargic for 5 months. He has noted increasing hesitancy with urination. On physical examination his prostate is diffusely enlarged. Laboratory studies show sodium 139 mmol/L, potassium 4.0 mmol/L, chloride 104 mmol/L, CO2 25 mmol/L, creatinine 1.9 mg/dL, and glucose 81 mg/dL. Which of the following renal abnormalities is most likely to be present in this man?

A Cortical atrophy
B Glomerulonephritis
C Papillary necrosis
D Polycystic change
E Renal cell carcinoma
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is it...E. renal cell carcinoma...
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Old 08-03-2011
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I think cortical atrophy due to back pressure
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Old 08-03-2011
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cortical atrophy cuz BPH causes hydronephrosis
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Old 08-03-2011
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a) cortical atrophy
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Old 08-03-2011
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why is the blood glucose 81??
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Old 08-03-2011
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hmm..even i think its cortical atrophy now
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Old 08-03-2011
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Quote:
Originally Posted by examtaker View Post
is it...E. renal cell carcinoma...
I dont think so,

RCC produces Renin which would in turn activate RAA so lots of aldosterone would lead to Increased Sodium Levels and Dec. Potassium (which isn't the case)

My guess is also Cortical Atrophy, but i'm 50/50 with paillary necrosis for some reason, he's old.. he's in pain.. chronic use of NSAID could have lead to Papillary Necrosis?
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A 72-year-old man has been feeling tired and lethargic for 5 months. He has noted increasing hesitancy with urination. On physical examination his prostate is diffusely enlarged. Laboratory studies show sodium 139 mmol/L, potassium 4.0 mmol/L, chloride 104 mmol/L, CO2 25 mmol/L, creatinine 1.9 mg/dL, and glucose 81 mg/dL. Which of the following renal abnormalities is most likely to be present in this man?

A Cortical atrophy

B Glomerulonephritis

C Papillary necrosis

D Polycystic change

E Renal cell carcinoma

increasing hesitancy with urination =>prostate is diffusely enlarged =>Cortical atrophy => creatinine 1.9 => metabolic acidosis
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cortical atrophy
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Old 08-04-2011
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Default Explanation

(A) CORRECT. The prostatic hyperplasia could lead to obstructive uropathy with hydronephrosis and eventual chronic renal failure.

(B) Incorrect. Obstructive uropathy can lead to an increased risk for infection with pyelonephritis, but not glomerulonephritis

(C) Incorrect. Papillary necrosis is an uncommon complication seen with diabetes mellitus.

(D) Incorrect. Polycystic change in adults can accompany dominant polycystic kidney disease or chronic hemodialysis.

E) Incorrect. Obstructive uropathy does not increase the risk for neoplasia.
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