P.W. is 23 years old. He was the victim of a hit-and-run auto-pedestrian acciden

Question

P.W. is 23 years old. He was the victim of a hit-and-run auto-pedestrian accident and suffered multiple abrasions, a concussion, and a deep laceration of his left thigh. He was discovered approximately 2 hours after the incident and is now in the emergency department. P.W.’s vital signs and hematocrit suggest that he has had a blood loss of about 2500 ml. A urinary catheter is inserted to monitor urine output, and fluid resuscitation is initiated while his wounds are cleaned and sutured. The urine output is averaging 15 ml/hr, with a high urine osmolality and low urine sodium.

Analyze this case study and answer the next four questions that follow.

Case-3: Question-4

If P.W.’s renal function does not return to normal, but continues to be diminished, what renal disorder might develop? (select all that apply)

Explanation / Answer

P.W. developed prerenal acute renal failure due to hypovolemia and oligouria resulting in renal insufficiency. If the renal function does not return to normal he may progress to acute tubular necrosis due to acute kidney injury (AKI). Therefore, option C is correct.

Nephrotic syndrome is caused by proteinuria and is a primary kidney disease.

Renal calculi is the condition of kidney stones obstructing the urinary tract and passage of urine.

Pyelonephritis is the infection of kidney resulting in inflammation of renal tissues.

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