Nbme 6 q

[step1april2013]

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Anyone remember what this answer was?

after sustaining severe burns, a 45 yo man becomes hypotensive for several hours. his urine output subsequently decreases to 150 ml/day for 3 days . microscopic examination of urine on the third day is most likely to show which of the following findings
a, casts containing renal tubular epithelium
b. large numbers of leukocytes
c. large numbers of uric acid crystals
d, numerous eosinophils
e. numerous oval fat bodies

 

[bangarang]

Anyone remember what this answer was?

after sustaining severe burns, a 45 yo man becomes hypotensive for several hours. his urine output subsequently decreases to 150 ml/day for 3 days . microscopic examination of urine on the third day is most likely to show which of the following findings
a, casts containing renal tubular epithelium
b. large numbers of leukocytes
c. large numbers of uric acid crystals
d, numerous eosinophils
e. numerous oval fat bodies

I think it was casts containing renal tubular epithelium. The hypotension causes hypoperfusion/ischemia of the kidneys, which can then cause tubular damage indicated by the renal tubular epithelial casts. It's on page 496, FA2013, under "Acute tubular necrosis."

 

[Jonari]

Anyone remember what this answer was?

after sustaining severe burns, a 45 yo man becomes hypotensive for several hours. his urine output subsequently decreases to 150 ml/day for 3 days . microscopic examination of urine on the third day is most likely to show which of the following findings
a, casts containing renal tubular epithelium
b. large numbers of leukocytes - wrong, because indicates acute pyelonephritis
c. large numbers of uric acid crystals - wrong
d, numerous eosinophils - wrong, because this is associated with acetominophen use, eosinophils is diagnostic for acute interstitial nephritis
e. numerous oval fat bodies - wrong, oval fat bodies...i can't recall but no, this is wrong

ATN as the poster above stated. should see "muddy brown" casts. also clue was patient being hypotensive and little urine output.

 

[blaqmamba]

ATN as the poster above stated. should see "muddy brown" casts. also clue was patient being hypotensive and little urine output.

for completion sake, oval fat bodies are associated with proteinuria (ie, nephrotic syndrome)

 

[Jonari]

for completion sake, oval fat bodies are associated with proteinuria (ie, nephrotic syndrome)

is the maltese cross aka oval fat bodies?

 

[blaqmamba]

is the maltese cross aka oval fat bodies?

yup.