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  #1  
Old 06-14-2012
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Urine Sample isolated proteinuria ...next step ?

A 26-year-old athletic woman comes to the office for a routine
visit. She jogs 2 to 5 miles per day and does not drink or smoke.
Her only complaint is some occasional "bone pain" in her right
lower leg when she runs. Her physical examination is
unremarkable. Routine laboratory studies show: potassium 4.5
mEq/L; creatinine 0.8 mg/dL; and hematocrit 42%. Urinalysis
shows a yellow color; pH 5.0; no white cells, red cells, or casts;
and there is 1+ protein. Your initial management of this patient
would be:
(A) Renal ultrasound
(B) 24-hour urine collection
(C) Split urine test
(D) Repeat urinalysis in 4 to 6 weeks
(E) Renal biopsy
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Old 06-14-2012
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-(D),PT athletic ;may be transiant protienurea
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Old 06-14-2012
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confused between B and D

id go with B
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Old 06-14-2012
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Quote:
Originally Posted by um aala View Post
-(D),PT athletic ;may be transiant protienurea
Agreed!

Very common in plp who stand up a lot too..
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Old 06-15-2012
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ans is to repeat after 4-6 weeks.

cant get good expln though..why not split urine firs t?
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Old 06-15-2012
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Quote:
Originally Posted by tyagee View Post
ans is to repeat after 4-6 weeks.

cant get good expln though..why not split urine firs t?
I think you may have misdiagnosed it.. its Orthostatic Proteinuria.. so I dont think we need to do anything for that..
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Old 06-15-2012
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Repeat Urinalysis, go with D
if its positive for protein then exclude any cause of transient proteinuria ex. exercise, fever, CHF. Can't identify any of transient proteinuria causes proceed with split urine test to exclude Orthostatic proteinuria.
If it's not orthostatic , then do 24 hr. urine collection.


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Quote:
Originally Posted by tyagee View Post
ans is to repeat after 4-6 weeks.

cant get good expln though..why not split urine firs t?
if u suspect transiant=repeat
if u suspect orthostatic=split
anad collect if gn
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Internal-Medicine-, Nephrology-, Step-2-Questions

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