A&P Basics BIOL 2404 Case Study: Renal System Dr. Weis
Internal Medicine Service
Admission Date:
Release Date:
Signalment: 48 year old male who is a professor at nearby university
CC: History of recent back pain with fluctuating intensity, now constant and dull
Previous History: NSF
Physical Exam: TPR within normal limits. Ausculation and BP were normal and there was slight nausea with abdominal palpation.
Tests performed were a CBC with chemistry profile, urinalysis, and spinal radiographs.
Results: CBC was within normal limits, chemistry profile revealed slight elevation in uric acid. Urinalysis revealed mild occult hematuria with pyuria , an alkaline pH, and urate crystals.
Radiographs of the spine were normal, but radiopaque renal calculi were noted.
Additional tests ordered were an IV pyelography and urine culture and sensitivity.
IV pyelography revealed three renal calculi less than 5 mm in diameter.
Assessment: Renal Calculi caused by gout
Treatment included rehydration with IV fluids, antimicrobial therapy, analgesics,
Allopurinol, and urinary acidifiers. All urine was strained through a tea strainer for the next 48 hours and urine pH was monitored. Body weight, fluid intake and output were recorded and renal function was assessed daily.
The three calculi were passed and stone analysis revealed a predominance of urate.
Plan: The patient was discharged with recommendations for dietary changes and continued monitoring of urine pH and to repeat the urinalysis in one month.