Question

Read scenario I. Then decide which of sentences A – J are correct (there are 5 correct ones) and which are incorrect. Answer questions 11 & 12 as they apply to scenario I. Scenario I:

Ms. Dolores Umbridge is a 63-year-old patient who has been on a nephrotoxic dose of antibiotics. She develops ATN (acute tubular necrosis) as a result. Her S&S are as follows: acute oliguria & generalized edema. Blood work: BUN = 27, creatinine = 3.0. UA: casts are noted.

A. This patient’s AKI (acute kidney injury) is considered to be in the prerenal AKI category because an acute event likely caused a low BP.

B. As cells of the tubules die, they slough off into the urinary tubules and are seen as “casts” in the analysis of the urine.

C. The patient is oliguric because when the kidney is “sick,” the GFR pathologically increases and allows too much urine to be filtered into tubules.

D. The following mini-concept map explains the patient’s edema: sick kidneys  diminished ability to decide how much Na+ and H2O should be secreted in the urine water is pathologically retained  fluid overload eventual edema.

E. As cells of the tubules die, they slough off into the urinary tubules then are reabsorbed into the peritubular capillaries, causing arterial blockages called casts.

F. The following mini-concept map explains the patient’s edema: slow, insidious disease process affects kidneys  over time, DCT becomes refractory to aldosterone Na+ and H2O are not retained as they should be and instead are secreted in the urine (water follows sodium) excess water in urine  fluid overload eventual edema.

G. This patient has a guarded prognosis because few people get better after having a pre-renal AKI, even after appropriate treatment.

H. This patient may have a good prognosis because many times people completely recover following appropriate treatment of an AKI.

I. This patient’s AKI (acute kidney injury) is considered to be in the intrarenal AKI category because an acute event has caused the tubules of the nephrons to become ischemic and malfunction.

J. The following explains the patient’s azotemia: in ATN, tubular cells die and there is diminishing renal function, including the loss of the ability to get rid of wastes.

11. Which one of the following is correct about the patient in the scenario?

a. A

b.B

c. C

d. E

12. All of the following are correct EXCEPT:

a. G

b. H

c. I

d. D

Answer 1

Option B,D,H,I,J are correct answered in this scenario.

11.Option B is correct .

As cells of the tubules die ,they slough of into urinary tubules and are seen as casts in the analysis of urine.

Casts in the urine indicates renal disease.

12.Option A.

G-This patient t has guarded prognosis becuasbfew people get better after having pre renal AKI even after appropriate treatment.

This option is incorrect for this scenario.