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A 6 yr old girl is brought to the physician because of dark urine and periorbital edema upon waking in the morning for the past 3 days. Physical exam shows mild hypertension and ankle swelling. Urinalysis shows the presence of red blood cells, red blood cell tubular casts, and increased protein concentration. Over the next few days urine output is decreased despite adequate fluid intake, what is the most likely location of the disease process
A: Glomerular
B: Interstitial
C: Postrenal
D: prerenal
E: Tubular
Please explain these questions always confuse me.....thanx
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anyone??? i could really use the help
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I think its A.
She has glomerulonephritis. Hypertension, Red cell cast, proteinuria, proteinuria.
Maybe poststreptococal...
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pt. presents with nephritic syndrome, most likely PSGN...
nephtitic = inflam. of glomerlus
PSGN = post strep GLOMERULOnephritis...
so my answer is A
Dr. Goljan said don't look for zebras... so i think this is just simple PSGN....
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C and D are definitely not the answer, cuz she neither has any sign of decreased renal perfusion ( hypotension) nor she has any sign of an obstructive lesion...
interstitial nephritis usually doesn't present in RBC casts... in interstitial nephritis, look always for epsinphils in the urine..
Tubular...mmmm... if we wanna thing for example of ATN!! the pt is too young for that, and there's not any granular case...
and finally, proteinuria, RBC CASTS are diagnostic and almost pathognomonic for an injury in the glomeruli...
