A 50-year-old man comes to his primary care physician’s office for routine follow-up. He was recently diagnosed with osteoarthritis of the knees four weeks ago and was initiated on analgesic medications. Past medical history is significant for diabetes mellitus. Current medications include metformin, naproxen and acetaminophen. His vitals and physical exam are within normal limits. Laboratory results are as follows. Laboratory value Results 4 weeks ago Today Serum chemistry Sodium 138 mEq/L 137 mEq/L Potassium 4 mEq/L 4.1 mEq/L Bicarbonate 24 mEq/L 25 mEq/L Chloride 96 mEq/L 94 mEq/L Creatinine 1.1 mg/dL 1.6 mg/dL Urinalysis Protein 100 mg/day 102 mg/day Cast None None Blood negative negative Changes to which of the following anatomic regions is most likely accountable for this patient’s rise in creatinine?

Renal papillary necrosis

3,614 views

Assessments
Renal papillary necrosis

Flashcards

0 / 6 complete

Questions

0 / 2 complete

High Yield Notes

10 pages

Flashcards

Renal papillary necrosis

6 flashcards

Questions

USMLE® Step 1 style questions USMLE

2 questions

Preview

A 50-year-old man comes to his primary care physician’s office for routine follow-up. He was recently diagnosed with osteoarthritis of the knees four weeks ago and was initiated on analgesic medications. Past medical history is significant for diabetes mellitus. Current medications include metformin, naproxen and acetaminophen. His vitals and physical exam are within normal limits. Laboratory results are as follows.

Laboratory value	Results
	4 weeks ago	Today
Serum chemistry
Sodium	138 mEq/L	137 mEq/L
Potassium	4 mEq/L	4.1 mEq/L
Bicarbonate	24 mEq/L	25 mEq/L
Chloride	96 mEq/L	94 mEq/L
Creatinine	1.1 mg/dL	1.6 mg/dL
Urinalysis
Protein	100 mg/day	102 mg/day
Cast	None	None
Blood	negative	negative