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The Man with the Swollen Leg

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Submitted By melissaw31
Words 255
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The Case of the Man with the Swollen Kidney and the Thirsty Woman
Melissa Williams
AP2630
November 14, 2014
ITT-Technical College

Mrs. Anderson
Clinical Presentation: * Polydipsia * Polyuria * Nocturia
Patient History * Manic depressive illness treated with Lithium * Asymptomatic when is allowed to drink massive volumes of water * Recently moves to supervised facility
Physical Exam: * Wrinkled skin * Dry mucous membrane * Disorientation * Lethargy * Confusion
Vital Signs: * BP: 70/55 * HR: 124/min
Test and Indications: * Blood test indicates elevated solute concentration; suggests severe wter loss due to dehydration * Urinalysis indicates significant increase due to kidneys inability to reabsorb water during urine formation; suggest a reduced ADH effect
Chemistry:
* Reabsorption of water depend on hormonal regulation
Cells:
* Principle cells in collecting duct
Tissues:
* Tubules are atrophic * Renal tubule are less responsive to ADH * Connective tissues exists between tubule
Organ systems: * Brain * Kidney * Skin * Blood * Vessels * Urinary bladder
MR. NEWMAN
Clinical presentation: * Fever * Severe flank
Patient History: * Bilateral lumbar tenderness * Bilateral renal enlargement * Liver enlargement * Ankle and facial edema * Skin pallor * Lung sounds suggest pulmonary edema
Vital signs: * BP: 172/100 * HR: 92 * Temp: 102.2
Test and Indications: * Blood test indicates anemia and infection * Urinalysis indicates loss of urine and renal disfunction
Chemistry:
* Potassium: 5.4 mEq/ liter * Calcium: 6.8mg/ dL * Phosphate: 4.3mEq/liter * Urea: 37mg/dL * Creatinine: 2.0mg/dL * Albumin: 2.9gm/ dL * pH: 7.29
Cells:
* Cysts in kidneys
Tissues:
* Renal (very little exists) * No renal cortex or renal medulla identified
Organ

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