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A
27 year old female was seen by medical personnel at an after
hours clinic. She complained of nausea and weakness.
Physical examination showed the patient had some edema. Since the
patient's medical record showed a history of diabetes, her family
physician was notified.
Further patient history
revealed the patient had been treated 2 weeks prior for a
recurring urinary tract infection with two types of antibiotics.
However, over the past week, the patient's urine output began to
decrease markedly. Alarmed by this information, the family's
physician ordered several series of blood tests STAT and asked
the patient's husband to transport her to the hospital for
admission and further evaluation.
The
following tests were ordered:
Complete
blood chemistry
CBC
Urinalysis
(Be sure to
view the photos of the cells and casts at this site.)
urine
clearance test
Instructor's
Notes:
Please review "Overview of the Urinary System" and "The Nephron"
in the Case Study Workbook with the accompanying activities.
The student may also want to review the following 2 websotes
including a YouTube video (isn't You Tube awesome!!!) that
shows an animation of the function of the neprhon.
Kidney
function
The
kidney
1.
What is the glomerulus?
2. What substances are filtered
through the capillaries?
3. What substances do not pass
through the filters of the kidney?
4. How does the
kidney maintain the proper pH balance and the proper balance of
water in the body?
5. What does the term reabsorption
refer to?
6. What does the term secretion refer to?
7.
What ion, secreted in the tubules, is important in maintaining
control of the acid/base balance (ph) of the blood?
8.
If the pH of the blood is dropping, how do the kidneys maintain
the proper pH?
9. What does the term excretion refer to?
This
patient's symptoms may well indicate the serious and
life-threatening condition know as acute
renal failure.
The broad definition certainly means the loss of kidney function
to some degree and is usually of sudden onset. At the kidney
level, this means a loss in the glomerular filtration rate. The
link above presents a good overview of the key points of renal
failure and links to basic kidney function. In this case
study, we will focus on acute
tubular necrosis
(ATN)
as a toxic side-effect of the antibiotics administered
previously.
10.
Acute tubular necrosis can be defined as.....?
11. What
are the risk factors for ATN?
Case questions 12-20 can
be found by linking to "Blood Chemistry and Urinalysis results
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