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 aregiven 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/L3.7 mmol/L4.9 mmol/L65 μmol/L314 mOsm/kg

Following diarrhoea and vomiting there is loss of water along with other important things like…

Answered: A 2-year-old child, admitted to…

Phlebotomy Essentials

6th Edition

ISBN:9781451194524

Author:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Publisher:Ruth McCall, Cathee M. Tankersley MT(ASCP)

Chapter1: Phlebotomy: Past And Present And The Healthcare Setting

Section: Chapter Questions

Problem 1SRQ

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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 receptors
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
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 alkalosis
A uremic patient has a urine output of 1.8 L/24 h and an average creatinine concentration of 2.2 mg/dL. What is the creatinine clearance? How would you adjust the dose of a drug normally given at 20 mg/kg every 6 hours in this patient (assume the urine creatinine concentration is 0.1 mg/mL and creatinine clearance is 100 mL/min)?
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)
The laboratory received a 24-hour urine collection from a 26-year old male (body surface area = 2.34m2), and the total urine collection volume measured 800 mL in 24 hours. After creatinine determinations were performed by the alkaline picrate method, interpret the result. Plasma creatinine: 1.2 mg/dL Urine creatinine: 150 mg/dL a. The creatinine clearance of the patient is above reference range. b. The creatinine clearance of the patient is below reference range. c. The creatinine clearance of the patient is within reference range. d. The creatinine clearance of the patient is borderline high.
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…
What 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 homework
For the past several months, a 24-year-old male has experienced fatigue, puffiness, and overall weakness. One day he noticed his urine had a red to brown discoloration, and that his urine volume was minimal. He went to the emergency room, where urinalysis, blood work, and other tests were done to obtain the following data: Urinalysis results Hematology results Appearance Red to brown Serum sodium 125 mEq/L Specific gravity 1.025 Serum potassium 6 mEq/L Blood Positive Serum creatinine 2.6 mg/dL Glucose Negative BUN 24.0 mg/dL Protein Mild pH (arterial) 7.32 Renal function tests Hematocrit 25% GFR (glom. filt. rate) 40 mL/min RBF (renal blood flow) 280 mL/min 1. What disorder is affecting this individual? What situation(s) predispose an individual to this disorder?
For the past several months, a 24-year-old male has experienced fatigue, puffiness, and overall weakness. One day he noticed his urine had a red to brown discoloration, and that his urine volume was minimal. He went to the emergency room, where urinalysis, blood work, and other tests were done to obtain the following data: Urinalysis results Hematology results Appearance Red to brown Serum sodium 125 mEq/L Specific gravity 1.025 Serum potassium 6 mEq/L Blood Positive Serum creatinine 2.6 mg/dL Glucose Negative BUN 24.0 mg/dL Protein Mild pH (arterial) 7.32 Renal function tests Hematocrit 25% GFR (glom. filt. rate) 40 mL/min RBF (renal blood flow) 280 mL/min 1. What disorder is affecting this individual? What situation(s) predispose an individual to this disorder? (4 pts) 2. Hyponatremia and hyperkalemia: A. Define these conditions. B. Describe a possible cause of each. 3. Why is there blood in the urine? 4. How do the renal function tests for this individual compare to a healthy…
1)Which of the following is NOT associated with a normal first-void urine finding? = trace protein positive glucose 0.1 urobilinogen pH of 6.0 2)A BUN of 60 mg/dL and a 3.5 mg/dL is consistent with which of the following? congestive heart failure nephrotic syndrome glomerulonephritis pyelonephritis 3)A sensitive test for the early detection of renal disease in diabetic patients is the ________________ test.= urine creatinine blood urea nitrogen urinary microalbumin urine pH = 4)An increased serum osmolality is associated with a decreased glomerular filtration rate. True False = 5)Select the influences below that will cause an elevated blood urea concentration. increased dietary protein decreased renal function increased protein catabolism pregnancy
A 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%

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