Miscellaneous
Diagnosis for a patient who complains of an acute onset of muscle pain, weakness and dark urine. CK levels are elevated.
What is Rhabdomyolysis?
Patients with rhabdo can have acute kidney failure related to the Myoglobins that are released from the damaged muscle cells.
CK levels will be elevated 5x the normal value or higher.
Patients may have a hx of severe exercise, crush injury, high fever, high dose statin. These patients should be referred to ED.
The presence of this in a U/A Is always abnormal in Males
What are leukocytes?
Normal WBC in urine are less than 2 to 5
U/A is a more sensitive test for infection in males than females
A normal response to acute blood loss will begin to show an increase in the reticulocyte count after a few days.
What is Reticulocytosis?
True/False: If normal levels of MCV, MCHC and RDW, then iron, vit B12 and folate deficiency is ruled out.
What is true?
Inability to maintain oral hydration, persistently high fever (>101), toxic appearance, immune compromise, or suspicion of sepsis or noncompliance to treatment are the indications for what?
What are indications for hospitalization for pyelonephritis?
Pyelonephritis presents with acute onset of fever, chills, nausea, dysuria, frequent urination, and unilateral flank pain.
Flank pain may be described as a deep ache
This laboratory value is affected by gender, race and muscle mass. Maybe be falsely decreased older adults.
What is serum creatinine?
Males have higher levels
African Americans have more muscle mass
Older adults have low muscle mass (falsely decreased)
Normal value: male 0.7-1.3 mg/dL, female 0.6 – 1.1 mg/dL
A significant drop in blood pressure that usually does not manifest until about 30% to 40% percent of the blood is lost.
What is Severe Hemorrhage?
Pernicious anemia is the most common form of this deficiency.
What is vitamin B12 deficiency?
Aminoglycosides, contrast agents, NSAIDs, ACE inhibitors, and protease inhibitors.
What are medications that cause AKI?
Patients normally present with acute onset of oliguria, edema, fluid retention, and complaints of lethargy nausea and loss function.
Elevated serum creatinine and decrease in kidney function
During early stages serum creatinine and eGFR may not accurately reflect true renal function.
Most cases of AKI are reversible once the medication causing it is stopped
The most common causes of mild neutropenia (absolute neutrophil count [ANC] > 1,000 cells/ml in adults
What are benign ethnic neutropenia and drug-induced neutropenia?
Type of anemia that presents with: decreased Hb, decreased Hct, decreased RBC, increased MCV, normal MCHC, increased RDW.
What is macrocytic normochromic anemia?
The main symptom for bladder cancer.
What is painless hematuria?
Hematuria can be microscopic or gross
Hematuria may only occur at the end of voiding
u/a, urine culture and sensitivity and urine cytology should be ordered.
An X-linked recessive disease that predominantly affects males who have only one X chromosome. It is the most common type of hemophilia in the United States
What is Hemophilia A?
The test(s) to order based on these results: decreased MCV, decreased MCHC, increased RDW.
What is Vitamin B12 and folate?
A 78 yr old male presents with hematuria, low back pain, lower abdominal pain, and perennial pain. Hx of HTN, DM, and current smoker. What will be your diagnostic approach?
what is UA, C&S, and Urine cytology?
A cancer of plasma cells and symptoms of fatigue, weakness, and bone pain located in the back.
What is Multiple Myeloma?
Food selection for patients with folic acid deficiency anemia.
Leafy green vegetables, grains, beans, liver.