Name: Sonia Parmar

Theme: Renal Function

 

OPTION LIST

 

A

Benign prostatic hypertrophy

I

Renal artery stenosis

B

Carcinoma of the prostate

J

Rhabdomyolysis

C

Diabetes mellitus

K

 

D

Diclofenac

L

 

E

Haemorrhage

M

 

F

Henoch-Schonlein purpura

N

 

G

IgA nephropathy

O

 

H

Multiple myeloma

P

 

 

Normal Values:

Hb – males: 13.5-17.5g/dl

Hb – females: 11.5 – 15.5g/dl

MCV: 76-98fl

WCC: 4-11 x 109/l

Plt: 150-400 x 109/l

Na+: 135-145mmol/l

K+: 3.5-5.0mmol/l

Urea: 2.5-6.5mmol/l

Cr: 50-120umol/l

CK: 23-175iu/l

 

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

 

1. A 35-year-old alcoholic presents to A&E with confusion and maleana. On examination, he has signs of chronic liver disease and is pale and clammy. BP is 90/50mmHg and he has a weak thready pulse of 130bpm. Investigations reveal FBC: Hb 6.3g/dl, MCV 108fl, WCC 3.8 x 109/l, Plt 23 x 109/l; U&Es: Na+ 123mmol/l, K+ 4.4mmol/l, urea 27mmol/l, Cr 123umol/l.

 

 

2. A 74-year-old man presents to his GP with increasing malaise and back pain associated with hesitancy and poor urinary stream. Subsequent investigations reveal U&Es: Na+ 134mmol/l, K+ 6.4mmol/l, urea 31.2mmol/l, Cr 1023umol/l; PSA 123nmol/l; bilateral hydronephrotic kidneys on USS.

 

 

3. A 61-year-old woman with kown peripheral vascular and ischaemic heart disease is started on an ACEi by her GP. 3 weeks later she is admitted to hospital with increasing confusion and pruritis. Investigations reveal FBC: Hb 12.3g/dl, MCV 85.2fl, WCC 6.8 x 109/l, Plt 403 x 109/l; U&Es: Na+ 130mmol/l, K+ 7.4 mmol/l, urea 37mmol/l, Cr 841umol/l; urinalysis – protein ++, ketones +, blood nil.

 

 

4. An 84-year-old woman is found collapsed in her flat by a neighbour. She had a fall 3 days prior to her rescue and had been unable to get up or raise the alarm. On admission to hospital investigations reveal FBC: Hb 15.3g/dl, MCV 91.2fl, WCC 23.1 x 09/l, Plt 403 x 109/l; U&Es: Na+ 145mmol/l, K+ 7.1mmol/l, urea 32.9mmol/l, Cr 649umol/l; CK 23,089iu/l.

 

 

5. A 24-year-old man presents to his GP with an increasing rash over his lower limbs and buttocks associated with arthralgia and haematuria. He is admitted to the local hospital where investigations reveal deranged renal function and a raised serum IgA.

 

 

 

ANSWERS

1. E

2. B

3. I

4. J

5. F