tommyk
10-05-2006, 12:59 PM
Hy 2421 Renal Physiology (remember to ALWAYS guess before peeking)
33-year-old woman named Zhang Ziyi is admitted to the hospital called House of Flying Daggers Memorial Hospital after being diagnosed with post-streptococcal glomerulonephritis. The patient was well until 3 weeks ago, when she noticed felt swelling and then blood in her urine. Two weeks prior to that, she had a severe upper respiratory infection, with a sore throat and high fevers. She sought no treatment at that time. She finally presents to you because her shoes no longer fit. On admission, her creatinine level was 7 mg/dL, and she was noted to have 1.5 g of protein in her urine per day. The patient had a dialysis catheter placed, and hemodialysis was started on hospital day 4 for hyperkalemia (Lab is given). Your attending who writes for the USMLE says she is going into RENAL FAILURE. Which of the following dietary supplements or regimens will most likely benefit this patient? Would her BONES be affected later if no treatment is given?
1-Low sugar diet
2-Low-fat diet
3-Low protein diet
4-High fat diet
5-Ca+ supplementation
6-Vit. C tabs
7-Vit. E tabs
a) Pick #5. Give Calcium. Renal failure wreaks havoc on a number of metabolic functions. One of these is calcium homeostasis. Renal failure patients waste calcium and develop secondary hyperparathyroidism in an attempt to correct the hypocalcemia. This leads to bone calcium deficits and pathologic bone lesions. Calcium supplementation slows this process. In this patient, a high-protein diet would worsen her renal condition. The other choices are similarly incorrect. Vit C and E would do little.
33-year-old woman named Zhang Ziyi is admitted to the hospital called House of Flying Daggers Memorial Hospital after being diagnosed with post-streptococcal glomerulonephritis. The patient was well until 3 weeks ago, when she noticed felt swelling and then blood in her urine. Two weeks prior to that, she had a severe upper respiratory infection, with a sore throat and high fevers. She sought no treatment at that time. She finally presents to you because her shoes no longer fit. On admission, her creatinine level was 7 mg/dL, and she was noted to have 1.5 g of protein in her urine per day. The patient had a dialysis catheter placed, and hemodialysis was started on hospital day 4 for hyperkalemia (Lab is given). Your attending who writes for the USMLE says she is going into RENAL FAILURE. Which of the following dietary supplements or regimens will most likely benefit this patient? Would her BONES be affected later if no treatment is given?
1-Low sugar diet
2-Low-fat diet
3-Low protein diet
4-High fat diet
5-Ca+ supplementation
6-Vit. C tabs
7-Vit. E tabs
a) Pick #5. Give Calcium. Renal failure wreaks havoc on a number of metabolic functions. One of these is calcium homeostasis. Renal failure patients waste calcium and develop secondary hyperparathyroidism in an attempt to correct the hypocalcemia. This leads to bone calcium deficits and pathologic bone lesions. Calcium supplementation slows this process. In this patient, a high-protein diet would worsen her renal condition. The other choices are similarly incorrect. Vit C and E would do little.