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Discussion Starter · #1 ·
A young African American woman has normal physical exam except lab study reveals microscopic hematuria, BUN and creat normal. what is the first step in work up?

:rolleyes: hint .... oxygen tension in renal medulla
 

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Discussion Starter · #3 ·
the answer is along the same thought process.
but the question is - what is the first step in workup

in renal papillary necrosis --> gross hematuria and proteinuria.

renal papillary necrosis may be associated with
Diabetes mellitus, Acute pyelonephritis, Chronic phenacetin use [acetaminophen is phenacetin derivative], and Sickle cell anemia
 

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Discussion Starter · #4 ·
first step in workup is - Sickle cell screen
WHY - This patent probably has sickle cell trait. Oxygen tension in renal medulla is low enough to induce sickling in peri-tubular capillaries leading to microinfarctions
 
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