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Case Study #2 History: Patient #2, a 57-year-old male, reports recent significant weight loss with increased appetite until past few days, then began to feel nauseated; significantly increased thirst and urination for many weeks; increasing fatigue over the last few months. BP 118/68 mmHg, RR 22 resp/min; Pulse 70 bpm; Temp 38.0oC. Skin remains slightly distended upon stress pinch. Additional Diagnostics: Microscopic evaluation reveals no significant findings. Questions for Patient #2: For Patient#2, the urine dipstick for this patient shows (mark all that apply): Leukocytes Protein pH is within normal limits but is acidic pH is within normal limits but is alkaline Blood Specific gravity is within normal limits, but is very low Specific gravity is within normal limits, but is very high Ketones Glucose No abnormal findings Under normal conditions, what happens to glucose in the nephron? It is not filtered through the glomerulus but remains in the blood It is filtered through the glomerulus and passes through to the urine It is filtered through the glomerulus and reabsorbed by the PCT It is filtered through the glomerulus and reabsorbed by the collecting duct It is filtered through the glomerulus but is not present in urine because it is metabolized by the cells of the transitional epithelium _________ are produced when cells metabolize fats for energy in the absence of carbohydrates. Amino acids Nucleic acids Triglycerides Proteins Ketones Excess glucose in urine can result because (choose all that apply) The PCT increases secretion of glucose The transport maximum in the PCT is exceeded by the amount of glucose filtered The PCT is damaged and is unable to reabsorb normally Decreased aquaporins in the collecting ducts allow more glucose to stay in the urine filtrate 5. Based on findings in the urine sample for patient #2, a possible cause for the patient’s increased respiratory rate would be: Over-hydration causing pulmonary edema Metabolic acidosis Respiratory alkalosis Prolonged vomiting A likely cause for this patient’s symptoms is: Systemic hypertension Diabetes mellitus Over-hydration from drinking too much water Diabetes insipidus (decreased ADH release) Excess aldosterone production SLE (systemic lupus erythematosus)

          Case Study #2
History:  Patient #2, a 57-year-old male, reports recent significant weight loss with increased appetite until past few days, then began to feel nauseated; significantly increased thirst and urination for many weeks; increasing fatigue over the last few months.  BP 118/68 mmHg, RR 22 resp/min; Pulse 70 bpm; Temp 38.0oC. Skin remains slightly distended upon stress pinch.

Additional Diagnostics:  Microscopic evaluation reveals no significant findings.

Questions for Patient #2:

For Patient#2, the urine dipstick for this patient shows (mark all that apply):
Leukocytes
Protein
pH is within normal limits but is acidic
pH is within normal limits but is alkaline
Blood
Specific gravity is within normal limits, but is very low
Specific gravity is within normal limits, but is very high
Ketones
Glucose
No abnormal findings
 
Under normal conditions, what happens to glucose in the nephron?
It is not filtered through the glomerulus but remains in the blood
It is filtered through the glomerulus and passes through to the urine
It is filtered through the glomerulus and reabsorbed by the PCT
It is filtered through the glomerulus and reabsorbed by the collecting duct
It is filtered through the glomerulus but is not present in urine because it is metabolized by the cells of the transitional epithelium

_________ are produced when cells metabolize fats for energy in the absence of carbohydrates.
Amino acids
Nucleic acids
Triglycerides
Proteins
Ketones

Excess glucose in urine can result because (choose all that apply)
The PCT increases secretion of glucose
The transport maximum in the PCT is exceeded by the amount of glucose filtered
The PCT is damaged and is unable to reabsorb normally
Decreased aquaporins in the collecting ducts allow more glucose to stay in the urine filtrate
 
   5. Based on findings in the urine sample for patient #2, a possible cause for the patient’s increased respiratory rate would be:
Over-hydration causing pulmonary edema
Metabolic acidosis
Respiratory alkalosis
Prolonged vomiting
 
A likely cause for this patient’s symptoms is:
Systemic hypertension
Diabetes mellitus
Over-hydration from drinking too much water
Diabetes insipidus (decreased ADH release)
Excess aldosterone production
SLE (systemic lupus erythematosus)

Added by Clarissa N.

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