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A 30 year old femal patient presented in the emergency department with 60% burns and musculoskeletal injuries. The patient was stabilized in the surgery department and a blood sample was sent for routine investigations. After 36 hours of admission, surgeon advised measurement of 24 hours urine output. Scenario 1 The patient responded to treatment and showed gradual improvement in health after 5 days of intensive care.
Question • 1) what is the probable etiology in this case? • 2) Enumerate clinical features? • 3) Explain pathophysiology for the same? • 4) Enumerate investigations advised in this case? • 5) Enumerate biochemical investigations ? • 6) Enumerate biochemical agents whose levels will be elevated? And why? • 7) What will be your Diagnosis in this case?
8) How you will treat this patient? • Scenario 2 • The 24 hour urine report showed urine volume < 300 ml and presence of myoglobin in urine. The patient was managed aggressively and after 3 days her urine output increased suddenly to 3000 ml in 24 hours. Patient recovered in another 4-5 days. • What is pathophysiolgy in this scenario? • What will be the diagnosis in this case?
3) what is the reason for oliguria and diuresis? • 4) If patient had died and autopsy was performed. Enumerate histopathological features of renal tissue?
A 75 year old male patient presented in the out-patient department with vomiting, thirst, irritability ,decreased urine output an azotemia. Medical history of patient revealed daily consumption of ACE inhibitors and insulin since past 10 years. • What is the diagnosis? • What is the etiology ?
What is the pathophysiology in this case? • What is azotemia and uremia? • Enumerate clinical features of uremia? • How you will investigate this patient? • Enumerate treatment modalities ?
