A 68 year old woman is admitted for vomiting and profuse diarrhea for 3 days. She is dizzy on standing and has dry mucous membranes. BUN is 46 mg/dL and creatinine is 1.6 mg/dL. Urine sodium is low and urine osmolality is high. Which of the following is the most likely explanation for her renal findings?

  1. A)Decreased renal perfusion with intact tubular reabsorptionGABARITO
  2. B)Immune mediated inflammation of the interstitium
  3. C)Obstruction of urinary flow causing hydronephrosis
  4. D)Destruction of podocytes causing heavy proteinuria
  5. E)Tubular epithelial necrosis with loss of concentrating ability

Explicação

This patient has prerenal azotemia from volume depletion. Because the tubules are still functioning, they avidly reabsorb sodium and water, producing low urine sodium, concentrated urine, and an elevated BUN to creatinine ratio. Ver explicação completa e trilha adaptativa →

Fazer o diagnóstico grátis de USMLE