A 35-year-old woman comes to the walk-in clinic with complaints of swollen ankles, puffy face and tight rings on her fingers. She has noted the swollen ankles and has been feeling fatigued for the last 6 weeks. The physician conducts an exam and notices that her blood pressure is elevated and there is generalized edema. He orders a UA, CBC, and BMP. Here are remarkable results.
UA
CBC
color
yellow
Hgb 11.0g/dl (12-15)
clarity
cloudy
Specific gravity
1.025
BMP
pH
6.5
BUN 22 mg/dl (5-20)
Glucose
negative
Creatinine 1.8 mg/dl (0.5-1.1)
Protein
4+
Ketone
negative
Blood
small
Bilirubin
negative
Nitrite
negative
Leukocyte esterase
trace
urobilinogen
0.1 EU
microscopic
Many Hyaline casts, 0-5 WBC/hpf, -05 RBC/hpf, few oval fat bodies
Questions
1. Based on the physician finding and the results given, what diagnosis might you suspect?
2. What 24- hour urine test may be helpful?
3. If a lipid panel is ordered, what would you expect the serum cholesterol and albumin to be?