A 31-year-old man presents with progressive weakness and fatigue. Vital signs: BP 138/88 mmHg, HR 92/min, RR 16/min, Temp 37°C, SpO2 98%. Laboratory studies reveal normal anion gap metabolic acidosis, serum potassium 3.2 mEq/L, serum glucose 95 mg/dL, urinalysis with glucosuria, phosphaturia, and aminoaciduria. Serum creatinine is normal. There is no proteinuria. Which portion of the nephron is primarily affected?

  1. A)Proximal tubuleGABARITO
  2. B)Collecting duct principal cell
  3. C)Thick ascending limb
  4. D)Distal convoluted tubule
  5. E)Macula densa

Explicação

Proximal tubule is correct. Type 2 renal tubular acidosis reflects impaired bicarbonate reabsorption in the proximal tubule. The additional glucosuria, phosphaturia, and aminoaciduria indicate Fanconi syndrome, which is a generalized proximal tubule dysfunctio... Ver explicação completa e trilha adaptativa →

Fazer o diagnóstico grátis de USMLE