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Two years after the initial appointment the man presents at the hospital. He has

ID: 3506212 • Letter: T

Question

Two years after the initial appointment the man presents at the hospital. He has been vomiting for two days following a fishing trip and has reported large amounts of bloodin vomit (suspected gastroesophageal variceal bleeding). He now weighs 102kg and presented with low blood pressure onadmission. Use the results from blood and urine analysis below for the rest of the calculations. Plasma Urine Result 126 mmol/L 6.4 mmol/L 12 mmol/L 93 mmol/L 15 mmol 30 mmH 200mol/L Reference Range 133-143 3.6-4.6 24-32 98-108 3.0-7.0 35-45 60-120 Result Reference Range Dipstick Protein Blood Albumin/Creatinine 0.41g/g

Explanation / Answer

We know that-

FENa = 100* (Urinary sodium*plasma creatinine)/(plasma sodium*urinary creatinine)

Calculating,

= (100*14*0.2)/(126*9)

= 280/1134

= 0.247

Serum Urea is also increased and blood pressure is decreased.

This is a sign of pre-renal acute kidney injury.

It may be due to cardiac failure.