Professional Documents
Culture Documents
• Anion Gap – 11
• ESR 62 CRP 0.1
What next?
• Diagnostics
o Labs
o Imaging
• Treatment
o Fix electrolytes and acidosis
• What type of fluids?
• Is he volume deplete as well?
• Frequency of lab monitoring?
Labs
• Urine studies
o Cath UA – large Hgb 6 RBCs, Large LCE, neg nitrite, 10 WBCs, trace glucose, 1+
protein, neg bacteria
o Urine Na - <20
o Urine Cl – 24
o Urine Cr – 7.2
o Urine K – 12.7
o Urine urea nitrogen - 118
o Urine Osm – 116 (low) (serum Osm normal at 286)
o FENa ~ 4.1%
o FE Urea 53.6%
o Urine anion gap – (Na + K – Cl) =~8
• What next?
• By the way, you just got a page – nurses required
multiple attempts to cath him
• Imaging
o VCUG (to evaluate for VUR and any bladder outlet obstruction)
o Diuretic renography (Mag 3 Lasix renal scan) to diagnose urinary tract
obstruction
• Can help identify level of renal function and any obstruction
• May not be required if VCUG is diagnostic