Case Study 31: Chronic Renal Failure - Santa Monica College
Case Study 31: Chronic Renal Failure Robyn Schwartz me o r d n y s ure t s a p
d o Go V + Case Study 31: Chronic Renal Failure Robyn Schwartz Past Medical history Went to ER 3 years ago
Coughing up blood for 6 hours Difficulty breathing Chills Chest pain Recently had influenza A
Lab results Elevated white blood cell count Iron deficiency Hepatosplenomegaly Enlarging of liver and spleen Crackles in the lung Past Medical history
ELISA test positive for GBM Elevated BUN Renal biopsy positive for IgG Immunoglobin antibody Goodpasture syndrome diagnosis GoodPasture syndrome
Rare Attacks lungs and kidneys Autoimmune disease Anti-glomerular basement membrane antigens (GBM) attack body Caused by immune hypersensitivity type II When antibodies of the immune system attach to antigens on the bodys own cells Antigens can be intrinsic or extrinsic Causes a B cell response GoodPasture syndrome
Rare Attacks lungs and kidneys Autoimmune disease Anti-glomerular basement membrane antigens (GBM) attack body Caused by immune hypersensitivity type II When antibodies of the immune system attach to antigens on the bodys own cells Antigens can be intrinsic or extrinsic Causes a B cell response Treatment
Put on methylpredisolone Used to treat severe allergic reactions, blood disorders Decreases immune response corticosteroid hormone Plasmapheresis 4 plasma exchanges of 1 L each daily for 2 weeks Cleans out blood
After 2 weeks symptoms resolved Maintained on azathioprine Used to prevent rejection in kidney transplants Reduces the proliferation of immune cells Lowers autoimmune response Also trimethoprim and sulfamethoxazole Antibiotics Reduce bacterial growth
Follow up 6 months later Urinalysis Low grade proteinuria and hematuria Presence of protein and blood in urine likely caused by the damage Goodpasture syndrome did to his kidneys Serum creatinine levels increased over the past 3 years Very close to end-stage renal disease Creatinine clearance levels 15.5 mL/min End stage is 15 mL/min Suggested course Dialysis
Kidney transplant Physical exam Skin Dry and flaky Very pale Lungs Mild bibasilar crackles Likely caused by fluid in lungs Extremities Mild edema of hands and feet Neurological
Alert CNs II-XII intact DTRs 2+ throughout Muscle tone 5/5 Positive Chvostek sign When the angle of the jaw is tapped the mouth and face will twitch Often associated with overactive sodium channels
FINAL STEP: BASK IN YOUR SHARED SUCCESS! Idea and Acceptance. AKA, should I agree to do this? Outline, Outline, Outline. Review the Literature. Become the Expert. Write. Get writers block. Write through the pain! Look at final draft with a...
times new roman arial calibri pulse 1_pulse microsoft clip gallery mail bomb recognition reasons for sending a mail bomb two types of bombs methods to trigger placed bombs triggering mail bombs common characteristics of letter & parcel bombs common characteristics...
Arial Tahoma Times New Roman Wingdings Curtain Call FERPA CONSIDERATIONS in running a student-based Academic Support mentoring program Academic Support is a Minefield … But some mines are more explosive than others … Let's Play FERPA Telephone! What would a...
Bioetanol yang perlu diproduksi di dalam negeri pada tahun 2009 untuk penyediaan Gasohol E-10 sebesar 420 ribu KL. Indikator global Brazil : sejak 1975 menggunakan Gasohol E-20 s/d E-25, (Program Pro Alcohol), produsen dan pengguna terbesar (> 11 juta kL/tahun).
Sailors could now handle the ship better at sea The Stern-post Rudder The stern-post-rudder Helped sailors to maintain a steadier course. The Astrolabe The Astrolabe The Astrolabe Was used to tell the location of the ship at seas using lines...
PLC Fe line Polarization of reflected radiation The polarization degree and angle depend on both h and the incl. angle (the latter may be estimated from the line profile; for MCG-6-30-15 is about 30 degrees, Tanaka et al. 1995) Variation...
Provide one-stop-shop on district website for information on leave. ... Have payroll run a report of every teacher who has exhausted sick leave balances but is not on a long-term leave. Run a report of any teacher who has taken...
Ready to download the document? Go ahead and hit continue!