Integrated Case

Question 1

1. Using a case-based analysis, realize the interaction and coexistence of multiple medical problems, such as acid-base abnormalities.

Answer 1

kidney failure can cause reduced NH4 production which can lead to Renal Acidosis Type IV (with hyperkalemia) with a normal anion gap (all RTA have no gap)

sodium bicarbonate may be a choice for tx. of metabolic acidosis

Question 2

1. Using a case-based analysis, realize the interaction and coexistence of multiple medical problems, such as electrolyte abnormalities..

Answer 2

crystal formation like that as a result of HIV meds can damage kidneys and reduce kidney function

to address hyperparathyroidism 1) control phosphate with decreased intake and also P binders, 2) address the cause- Vit D shortage

Question 3

1. Using a case-based analysis, realize the interaction and coexistence of multiple medical problems, such as volume status issue.

Answer 3

with nephrotic syndrome, you sell loss of ECV and urine osmolality will be determined by ADH; urine Na+ is the closest to an accurate marker for ECF volume

Question 4

1. Using a case-based analysis, realize the interaction and coexistence of multiple medical problems, such as acute and chronic kidney disease.

Answer 4

HIV/AIDS closely related to the development of collapsing FSGS (proliferation of podocytes due to direct infections with HIV)

with kidney failure the tx. goal for anemia is to keep the Hb between 10-12g/dL