Renal failure Quiz: Ace Your Exams
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A 65-year-old man comes to the emergency department for evaluation of lower abdominal discomfort for an hour. He has not urinated since yesterday and has had difficulty initiating urination for the past three months. He has not had weight loss, dysuria, urgency, or dribbling of urine. The patient had a viral illness two days ago for which he started taking acetaminophen for fever. Current vitals are within normal limits. Physical examination demonstrates a palpable mass in the suprapubic area. A symmetric, enlarged non-tender prostate is palpated on digital rectal examination. Glomerular filtration rate is 40 mL/min/1.73m2 (reference range: 90-120 mL/min/1.73m2). Urinalysis is shown.
If left untreated, which of the following laboratory findings are most likely to be observed in the coming weeks?
| Laboratory value | Result | Reference range |
| Serum chemistry | ||
| Blood urea nitrogen | 36 mg/dL | 7-18 mg/dL |
| Creatinine | 1.9 mg/dL | 0.6-1.2 mg/dL |
| Urinalysis | ||
| Proteinuria | None | None |
| Dysmorphic red blood cells | None | None |
| Sodium (UNa) | 15 mEq/L | 20 mEq/L |
| Fractional excretion of sodium (FENa) | <1% | 1-2% |
| Urine osmolality | 650 mOsm/kg | 50-1,400 mOsm/kg |
| Sediment | None | None |
If left untreated, which of the following laboratory findings are most likely to be observed in the coming weeks?
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