Sample A0
The urine sample provided was clear and yellow with no frothing indicating that there was little or no protein in the urine. The sample contained no cells or crystals but did contain a small number of hyaline casts. The lack of cells indicates the filtration membrane is at least partially intact, the casts are not necessarily associated with pathology and are more likely due to exercise or dehydration although can be due to renal failure (Serafini-Cessi, Malagolini and Cavallone 2003). Dehydration and exercise decrease the urine output due to vasoconstriction of the renal arteries, stimulating the release of Tamm-Horsfall protein to help protect against calcium crystallisation and UTIs (Serafini-Cessi, Malagolini and Cavallone 2003).
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We were told the patient had oliguria which is low urine output, the patient passed 100ml in 24 hours which is well below the normal 750ml. This indicates some serious damage somewhere in the genitourinary system but this does necessarily indicate a kidney prognosis and could be due to other organ pathologies which cause low urine output such as prostatitis or a UTI (Klahr and Miller 1998). Microscopic analysis of the urine revealed high numbers of red blood cells both burst and intact and red blood cell casts but no crystals. This is evidence for damage to the kidneys as bleeding further down the urinary tract e.g. the bladder would be less likely to result in burst cells in the urine plus the formation of red blood cell casts is an indicator of glomerular damage such as inflammation (Sigala, Biava and Hulter 1978). The dipstick confirmed the presence of protein at 30mg/dL and also showed there were 250 ERY/uL with normal glucose levels. While the protein level is not that high, the number of red blood cells is huge, this is a clear indicator of glomerular damage as the filtration membrane is clearly not functional, as there are blood cells in the urine, the fenestrated endothelium is likely damaged. The GFR of 20 ml/min/1.73m2 is extremely low, indicating severely decreased function (Medsci 301 Course Guide 2015), providing further evidence for damage to the glomerulus as this is where filtration occurs. When observing the photomicrographs, the glomeruli are hard to see amongst large amounts of hyaline material, there is clearly an exudate in capsular space and there are large numbers of inflammatory cells. All these factors point to inflammation as the cause of the damage as this would cause the deposition of the hyaline material, lead to the exudate as vascular permeability is increased and also lead to the infiltration of immune cells into the reactive tissue.
In this experiment, contractions of the earthworm gut are measured in an organ bath with a force transducer. The effect of neurotransmitters and ionic concentrations on contraction strength and rate will be investigated.
Injury to the glomerulus and the tubules presents the onset of Intra-renal failure (Matzke, 2011). Some of the frequent causes for Intra-renal failure are glomerulonephritis; pyelonephritis; and tubular injury. Post-renal failure develops from things like ureteroliths, tumors, or anatomic impediments. Opposite of the acute form, the chronic form has a slow onset that has no early stage symptoms. It is important to know that following an acute episode a chronic renal episode often follows, and at this juncture the damage is irreversible. Glomerulonephritis and pyelonephritis combined, has been reported to be the forerunner in as much as half the cases from acute to chronic renal failure. Diabetes mellitus, renal vascular disease, such as atherosclerosis, hypertension, polycystic kidney disease, drug damage, and nephrolith are all examples of other causes of CKD (Pradeep, 2014). Biopsies of kidneys that suffered with CKD reveal smaller kidneys with scarring on the tubules.
*Endocrine glands produce – hormones, they work with other hormones to perform many functions including: control water & electrolyte balance, regulating carbohydrate metabolism, working as neurotransmitters, maintaining stress & inflammation, regulate reproductive functions
Acute renal failure occurs quickly over a period of days or weeks with a reduction in GFR and elevation of BUN, plasma creatinine and crystatin C levels. Oliguria (urine output of < 30ml/hr or < 400 ml/day) is usually associated with ARF, although urine output may be normal or increased as well. Fluid is still filtered at the glomerulus but there is an alteration in tubular secretion or reabsorption. Most types of ARF are reversible if diagnosed and treated early (Perrin, 2009).
A sample of urine was taken from a patient with kidney disease was labeled as
A visit note from Dr. Robert Hendren (Urology), dated 09/20/2017, indicated that the claimant continued to have urinary frequency, urgency, and urge incontinence that required her 2 pads per day. She had microscopic hematuria noted on 08/31/2017. She had 3+ blood on urinalysis during the visit, but she had been undergoing her menstrual period. She had complaints of pain in the stomach, left arm, right leg, and foot. Urinalysis showed moderate blood with 30+ protein. Her BMI was 32.12. She was diagnosed with urge incontinence and hematuria. Cystoscopy was recommended.
This 60 year old Hispanic male presents at the clinic today with a chief complaint of urinary frequency, decreased urine flow, increased nocturia, slight terminal dysuria and low grade fever. The patient was experiencing these symptoms for the past two years, but they had increased a whole lot more during the last two weeks. Upon assessment, it is noted that the patient has a
M.T. has a 1-year history of atrial fibrillation. She takes warfarin daily, and her INR is within the therapeutic range, between 2 and 3. Her creatinine level is 1.3 mg/dL, and a normal level is 0.6-1.2 mg/dl for women. This indicates that she has slightly reduced renal function at this time, possibly due to her diabetes, medications, age, or urinary tract infection (UTI). She has been diagnosed with acute uncomplicated UTI. The 24-hour history of dysuria, urinary frequency, and urgency combined with the urinalysis result
Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of
CKD will cause the body to retain many excess fluids and waste that are normally filtered out to prevent internal harm throughout the body. With kidney disease there will be a rise in blood pressure due to the amount of extra fluid that is retained in the blood vessels. This fluid retention will cause the passageways to become narrow and make blood passage through the vessels increasingly difficult, in turn causing an increase in blood pressure. There will also be an increase in protein and blood found in the urine because it is not filtered out properly by the kidneys. Swelling will occur in the extremities and around the eyes because of the fluid retention as well. The longer the urine goes unfiltered the harder it may become to urinate due to pain or blockage or there may be more frequent night time urination (The National Kidney Foundation, 12).
The endocrine system is a group of glands distributed throughout the human body. This group of glands secretes substances called hormones. These hormones are dumping into the bloodstream (Shier, Butler & Lewis, 2009). The endocrine system does not have a single anatomic location. It is dispersed throughout the human body. The final purpose of this process is to control, regulate, and coordinate the functioning of the human body. Some body functions can be activated or inhibited by hormones, which are secreted in very small quantities. The hormone related diseases may be due to hyper secretion, or a hypo secretion. The hormones secreted by the endocrine glands regulate growth, development and function of many tissues, and coordinate the
Chronic kidney disease (CKD) is an irreversible condition that progresses causing kidney dysfunction and then to kidney failure. It is classified by a GFR of <60mL/min for longer than 3 months. There are five stages of CKD: Stage 1 has kidney damage but has a GFR ≥ 90. Stage 2 has mild damage and a GFR of 60-89. Stage 3 has moderate damage and a GFR of 30-59. Stage 4 has severe damage and a GFR of 15-29. Stage 5 is also known as end stage renal disease (ESRD), this is kidney failure with a GFR of ≤ 15 and theses patients are typically on dialysis or in need of an immediate transplant. The leading cause of CKD is diabetes. Hypertension is also a major cause. Since most DM patients have HTN,
Mr. Armstrong has a history of renal insufficiency and uncontrolled hypertension, along with symptoms of fatigue, pedal edema, and occasional shortness of breath. He does not have a history of trauma or obstruction to his kidneys, but his creatinine and BUN levels are currently at 3.5 mg/dl and 40 mg/dl. Normal creatinine concentration values are 0.7 to 1.2 mg/dl and normal BUN values are 10 to 20 mg/dl; this reveals that Mr. Armstrong’s kidneys are not removing wastes properly (McCance, Huether, Brashers, & Rote, 2014). Mr. Armstrong’s history of renal insufficiency and uncontrolled hypertension is commonly found in patients diagnosed with intrarenal (intrinsic) acute renal failure. Intrarenal acute renal failure can be categorized as
There is a pair of kidneys in the human body. They are situated towards the back of the body under the ribs, just at the level of the waist where one on either side of the body. Each kidney is composed of about one million units which are called nephrons and each nephron consists of two parts: a filter which is called the glomerulus and a tubule leading out from the nephron (Cameron 1999). According to Marshall and Bangert (2008) the kidneys have three major functions. Firstly, the kidneys are excretion of waste from plasma in the blood. The second function is that, they maintain of extracellular fluid volume and composition. Lastly, the kidneys have a role in hormone synthesis.
stage is moderate, glomerular filtration rate (GFR) in the kidney has been reduced.7Yet, kidney still