The patient fails to follow her doctor’s orders to change her diet. After 5 years have passed, she returns to the doctor with malaise (fatique), puffy eyelids, and abdominal pain. She is experiencing gradual loss of eyesight and parallel white lines on the beds of her fingernails. Follow up urinalysis results are as follows:
Chemical
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Microscopic
15-20 RBC/hpf
5-10 Renal Tubular cells/hpf
15-20 WBC/hpf
0-5 Squamous Epithelial cells/hpf
10-20 Hyaline casts/lpf
Questions
Click here for previous urinalysis results
1) What is present in this picture that is consistent with the diagnosis?
a. mucous
b. bacteria
c. yeast
d. hyaline
casts
2) What is this patient’s present diagnosis?
a. the
patient now has a urinary tract infection
b. the
patient’s initial condition has progressed to nephrotic syndrome
c. she
is probably pregnant
d. systemic
lupus erythrematosis
3) What protein is present in this patient’s urine?
a. hemoglobin
b. albumin
c. Bence
Jones light chains
d. C
Reactive Protein
4) In addition to the element in the picture, and the
elements already listed in the microscopic exam,
what other elements could also be
present?
a. WBC
casts
b.
RBC casts
c. Fatty
and waxy casts
d. All
of the above
5) True
or
False
: Lipiduria and the presence of oval fat bodies may also be symptoms
in this disease
6) If this patient continues to go untreated, what is the probable prognosis?
a. progression
into chronic renal failure
b. development
of renal cancer
c. cirrhosis
d. Multiple
myeloma
7) What is most likely the cause of the squamous epithelial cells?
