clinical chemistry 7 ed lippincott A 68-year-old female was admitted to the hosp

Question

clinical chemistry 7 ed lippincott A 68-year-old female was admitted to the hospital because of a four-month history of hypotension upon standing and fainting spells which were resistant to treatment. Physical examination showed edema and blood pressure of 80/50 mm Hg when seated which dropped lower upon standing. An admission urine exam revealed proteinuria. Pertinent laboratory data are as follows: BUN 12 mg/dL Creatinine 0.8 mg/dL Glucose 95 mg/dL Cholesterol 320 mg/dL Urinary protein 4+ Oval Fat Bodies Present Total Protein 3.0 g/dL Albumin 0.6 g/dL 24-hour urine protein 4.30 g 1. What is the most likely diagnosis? 2. What laboratory values are of significance in the diagnosis of this patient’s condition? 3. What are the diagnostic criteria for this disorder? 4. What are causes of this disorder? 5. Suggest a possible explanation for the patient’s hypotension upon standing. williams

Explanation / Answer

1. The most likely diagnosis is low blood pressure and progressive kidney damage.

2. The labaratory values that are of significance in the diagnosis of this patient's condition are low blood pressure, high cholesterol (320 mg/dL), and high values of 24 hr urine protein. The 24h urine values are considerabley high, at 4.3 g, whereas the normal values are around 300 mg/24 h.

3. Ultrasound of kidney, angiogram

4. The possible causes of this disorder could be bradycardia, heart valve problems, heart attack, dehydration, diabetes, and old age.

5. The patient has high cholesterol levels which indicate a probable block of blood vessels. Progressive kidney damage may also be a contributing factor.

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