A 60-year-old woman with history of lung cancer is admitted for weakness and lethargy for 4 weeks. Her serum [Na*] is 120 mEq/L. She weighs 60 kg. Her serum osmolality is 250 mOsm/kg H2O with urine osmolality of 616 mOsm/kg H2O. The diagnosis of SIADH is made. What would be her serum [Na], if she receives 1 L of isotonic saline? A. 122 mEq/L B. 116 mEq/L C. 118 mEq/L D. 120 mEq/L E. 124 mEq/L
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- A 3-month-old boy is brought to the emergency department because of a 20day history of lethargy. Physical examination shows no other abnormalities. The results of laboratory studies are shown: serum: Na+ 165 mEa/L (N=139-146) Cl- 130 mEq/L (N=95-105) Osmolality 334 mOsmol/kg H2O (N=282-295) urine: specific gravity 1.001 osmolality 117 mOsmol/kg H2O (N>200) He is admitted to the hospital. His urine output is increased. His serum ADH (vasopressin) concentraion is 24 pg/mL (N=1-5); aldosterone and renin concentrations are within the reference ranges. The urine osmolality remains unchanges after administration of 1-deamino-B-arginine vasopressin. An MRI of the brain and pituitary gland shows no abnormalities. Ultrasonography shows normal kidneys. The most likely underlying cause of the findings in this patient is a defect in which of the following?a. angiotensin-converting enzyme b. aquaporin c. 11a-Hydroxylase d. renin e. vasopressin receptorsA 68-year old woman presents with hypertension and oliguria. A CT of the abdomen reveals a hypoplastic left kidney. based on the following laboratory data which of the following is her estimated RPF? Renal artery p-amino hippuric acid (PAH) = 6mg/dL Renal vein PAH = 0.6mg/dL urinary PAH = 25mg/mL urine flow= 1.5mL/min hematocrit = 40%A 2-year-old child, admitted to hospital following diarrhoea and vomiting, had the fol- lowing results on analysis of plasma, 24 hours after admission (reference ranges are given in brackets): Sodium (135-145) Potassium (3.5-5.0) Urea (3.5-6.6) Creatinine (70-150) Osmolality (285-305) The urine sodium concentration was 55 mmol/L and its osmolality was 314 mOsm/kg. Comment on these results. 151 mmol/L 3.7 mmol/L 4.9 mmol/L 65 μmol/L 314 mOsm/kg
- Table 3. Serum creatinine values at admission and after 12h Admission +12h SCR(mg/dL) 1.55 1.42 Using the “MDRD” (Modification of Diet in Renal Disease) equation for estimating glomerularfiltration, provided below, and the data available in the above table, calculate the patient's (a 34 year old white male) estimated glomerularfiltration rate (eGFR) at admission and 12h after admission.MDRD GFR Equation (mL/min/1.73 m2)= 175 × (Scr)-1.154 × (Age)-0.203 × (0.742 if female) × (1.212 if African American)Based on your calculated values, state whether LF’s function is normal or abnormal?Previous research suggests that patients with asthma have an increased risk for chronic kidneydisease, but the mechanisms underlying this increased risk are poorly understood. Propose one potential mechanism by which asthma might impair kidney function, and discuss how this dysfunction may impair thebody’s ability to respond to respiratory alkalosisWhat is the patient's creatinine clearance given the following data? Serum creatinine 0.6 mg/dL Urine creatinine 102 mg/dL 24 hr urine volume 1650 mL Patient's BSA 1.93 m2 1) 195 mL/min 2) 130 mg/dL 3) 93 mL/min 4) 175 mL/min no references, just homeworkPatient A is 65 years old female. She has been diagnosed with diabetes Type II. Recently she experienced a gastrointestinal illness with nausea and vomiting. Lab data have been obtained the following day after her illness: Body weight 85 kg; Blood pressure 140/90 mmHg; Blood pH – 7.48; PCO2 – 44 mm Hg; Plasma HCO3 ion -32 mEq/L; Urine pH – 7.5. What is acid-base disorder of this patient. What was a main cause of this? The illness continues and after 2 days the following laboratory data have been obtained: Body weight 83 kg; Blood pressure 120/70 mmHg; Blood pH – 7.50; PCO2 – 48 mm Hg; Plasma HCO3 ion -36 mEq/L; Urine pH – 6.0. Has acid-base disbalance been changed? If yes, what is the explanation for this acid-base disbalance? Is there any compensation?
- Hematology Data: 24 hour urine volume: 1,000 mL; Serum Creatinine: 2.0 mg/dL; Urine Creatinine: 200 mg/dL What's the calculation for the Creatinine clearance? Please show steps, thank you!In reviewing the patient’s current information, a concern exists that acute kidney injury has developed. Select to highlight the laboratory information that would support this concern.UrinalysisCasts - +++Cola-color to urineProteinuriaBlood ValuesRBC - 3.9 cells/L (4.0-4.9 cells/L)Hgb 10 g/dL (12-16 g/dL)Hct-40% (37%-48%)WBC 11.0 cells/L (4.0-10.0 cells/L)Platelets - 140 cells/L (150-450 cells/L)Sodium - 140 mEq/L (135-145 mEq/L)Potassium - 4.5 mEq/L (3.5-5.2 mEq/L)BUN - 32 mg/dL (5-20 mg/dL)Creatinine 1.8 mg/dL (0.5-1.5 mg/dL)Blood Glucose - 180 mg/dL (nonfasting) (<200 mg/dL)AST-40 Units/mL (5-40 Units/mL)ALT - 30 Units/mL (5-35 Units/mL)Bilirubin (total)- 0.8 mg/dL (<1.0 mg/dL)Albumin - 4.0 (3.5-5.5 g/dL)PT-22 (11.5-14 seconds)Consider a 24 y/o 90 Kg male who has a blood glucose of 500 mg/dl. Glomerular function is normal and urinary flow rate is 3.88 L /day. What is the best estimate of his urinary glucose concentration?
- In renal tubular failure, serum levels of B2 microglobulin are decreased and urine levels are increased. True or FalseCalculate net filtration pressure given the following values: glomerular hydrostatic pressure = 50 mm Hg, blood colloid osmotic pressure = 25 mm Hg, capsular hydrostatic pressure = 20 Hg.An 85 year old women with a history of diabetes mellitus and a broken hip has been confined to bed for 3 months. She has been complaining of aching muscles and her recent blood glucose result is 250mg/dL (Normal Range 70 - 100mg/dL) Urinalysis is with the following results: Color: Reddish brown Appearance: Clear Sp Gr: 1.020, pн 5.0 Protein: 2+ Glucose: 100 mg/dL (3+) Ketones: Negative Blood: Moderate Bilirubin: Negative Urobilinogen: Normal Nitrite: Negative Leukocyte esterase: Negative Microscopic exam: 0 – 2 WBC/hpf; few squamous epithelial cells/hpf Questions (3): A. What is the significance of the negative Ketones result? a. Increased fat metabolism b. Fat is not being metabolized for energy c. Starvation d. Patient has just consumed a high fat meal B. Glucose will appear in the urine when the: a. Blood level of glucose is greater than 180 mg/dL b. Tm (Transport maximum) for glucose in tubular cells is exceeded c. Renal threshold for glucose is exceeded d. All of the above C. The…