Thoughtful Thursday: Florence Feels Feeble (Case 2)

 

Photo of Professor Pocky taken by Dr. Haus

Click For Explanation of Case Flow

 

Click for Test Case Tuesday:  Florence Feels Feeble

Diagnostic Testing Results - Reminder: 

CBC (Complete Blood Count)

Red Blood Cells - Low (Anemia)

 

CHEM (Chemistry)

Renal values consistent with a renal (intrarenal) injury

Calcium - Low (hypocalcemia)

 

Urinalysis (UA)

Electrolyte values consistent with a renal (intrarenal) injury

Extremely dilute urine

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Diagnosis:

✨CHRONIC KIDNEY DISEASE (FAILURE)✨

 

Pathophysiological Point:

Florence is suffering from a disease where her body's nephrons (kidney cells) are slowly dying.  This means her kidneys are slowly shutting down.

 

 Questions:

Level 1 Questions:

1.  Explain what the kidneys do and why they are important.
   
   
2.  If Florence has dilute urine, what does she need to have access to AT ALL TIMES?  (HINT:  Dilute urine means Florence is peeing out more water than normal)
   
   
3.  Challenge question, why does Florence have a low number of red blood cells in her body?  (HINT:  For this one you will need to do some information gathering on the kidneys' different jobs)
   

 

Level 2 Questions:

1.  Explain pathophysiologically why Florence has pale gums on physical exam and is anemic on blood work.  Be sure to explain all the steps of the process that is NOT occurring in Florence due to her chronic kidney disease.
   
   
2.  Urea is a waste product that is normally urinated out of a patient's body via their kidneys and is an acid.  What acid-base status would you expect in Florence's bloodstream?
   
   
3.  Challenge question, what TWO compensatory mechanisms are activated in Florence's body (there are two – assume the juxtaglomerular cells are still functional)?  (HINT:  Think about Florence's dilute urine)
   

    
   

Level 3 Questions:

1.   Describe the treatment plan you would recommend for Florence and why you are recommending each part of your treatment plan.  Please answer this question as if you are speaking to a professional colleague.
   
   
2.  Describe your recommended treatment plan and why you are recommending each part of your treatment plan.  Please answer this question as if you are explaining it to a client/patient without a scientific background.
   
   
3.  Explain the pathophysiology of at least TWO (2) different etiologies of Chronic Kidney Disease.
   

  

Day 2 Conclusion

Before Conclusion Caturday think about your...

❓Answers to the above questions

📚 Review Material Related to Florence's Case

 

Conclusion Caturday:  Florence Feels Feeble (link will go live Saturday, 10/28/2023)