| Symptoms
& History
Physical
Findings
Stop
& Think
Lab
and X-Ray
Differential
Diagnosis
The
Disease
Treatment
Conclusions
Quiz
& Evaluation |
|
We're
almost there.
-
The chemistry analysis shows
a significant elevation of BUN, is this indicative of incipient renal failure?
If not, what's a better explanation? The
BUN is an indirect expression of the urea concentration in the blood. Elevations
may reflect renal clearance rates, state of hydration or degree of protein
metabolism, specifically absorption from digested food. Has Mr. Jones just
had a protein rich meal?
-
Mr. Jones' hemoglobin and hematocrit
are dangerously low. Why then is the MCV, MCH and MCHC not proportionately
affected? When considering causes of
anemias, we must examine quantity and quality of RBCs. Mr. Jones has experienced
a sudden and dramatic loss of quantity. The measures listed here give us
clues as to the qualitative production of RBCs. In other words, availability
of construction materials, such as vitamins and iron. Is there really any
indication that his anemia is on the basis of diminished levels of raw
materials?
Continue |
|