Cazuri renal

Cazuri renal 1. Barbat, 46 ani se prezinta la medic acuzand fatigabilitate, disurie, febra, frison.  Proteine totale = 7,8 g/dL  Albumine = 4,4 g/dL  α1-globuline = nivel crescut  α2- globuline = nivel crescut  β- globuline = nivel normal  γ- globuline = nivel crescut  Fibrinogen = 580 mg/dL  PCR = nivel crescut  VSH = nivel crescut  Leucociturie = 96/mmc  Hematurie = 18/mmc  Cilindri leucocitari prezenti  Uree – 38mg/dl  Creatinina – 1,5mg/dl 2. Femeie, 66 ani se prezinta la medic acuzand disurie, lombalgii, febra, frison. • Proteine totale = 7,4 g/dL • Albumine = 3,9 g/dL • α1-globuline = nivel crescut • α2- globuline = nivel crescut • β- globuline = nivel normal • γ- globuline = nivel normal • Fibrinogen = 630 mg/dL • PCR = nivel crescut • VSH = nivel crescut • Leucociturie = 104/mmc • Hematurie = 28/mmc • BUN/creatinina - 15 • Nitriti - +++ • pH urinar – 4,1 • Sediment urinar cu: celule epiteliale de tranzitie (++), cristale de a. uric 3. Femeie, 62 ani cu HTA, edeme gambiere si palpebrale, tromboze periferice recurente Parametri

Valori normale

Valori masurate

Proteinemie (g/dl)

6,5 – 8,5

4,2mg/dl

Albumina

50-60

35

Alfa 1 globuline

3-4

3,2

Alfa 2 globuline

6-9

11

Beta globuline

10-12

14

Gama globuline

18-20

37

TQ

12-15s

8s

Electroforeză (%)

1

TG

<150mg/dl

420mg/dl

LDL

<100mg/dl

160mg/dl

Colesterol total

<200mg.dl

310mg/dl

4. Barbat, 71 ani se prezinta la medic acuzand fatigabilitate, polipnee, parestezii, scaderea capacitatii de efort, dureri precordiale. • Proteine totale = 7,8 g/dL • Albumine = 4,4 g/dL • Fibrinogen = 580 mg/dL • PCR = nivel crescut • Leucociturie = 5/mmc • Hematurie = 3/mmc • Creatinkinaza – 802UI/L • GOT - 415UI/L • GPT – 182 UI/L • LDH – 910 UI/L • Uree – 54mg/dl • Creatinina – 4,2mg/dl • pH arterial – 7,1 • HCO3 – 8mEq/L • PaCO2 - 68mmHg 5. Barbat 68 ani se prezinta la medic acuzand dispnee progresiva, fatigabilitate • Proteine totale = 6,4 g/dL • Albumine = 3,14 g/dL • Fibrinogen = 490 mg/dL • Proteinurie – 380mg/24h • Uree – 58mg/dl • Creatinina – 2,7 • Diureza 0,33ml/kg/h timp de 12h • pH arterial – 7,36 • HCO3 – 18mEq/L • PaCO2 - 68mmHg • Ecografie: rinichi cu contur neregulat, dismorfici, cu indice parenchimatos de 10; imagini litiazice renale bilaterale, neobstructive 6. Barbat 27 ani se prezinta la medic acuzand dispnee progresiva, palpitatii, lombalgii • Proteine totale = 6,2 g/dL • Albumine = 3,14 g/dL • Fibrinogen = 490 mg/dL • Proteinurie – 2,3g/24h • Diureza 650ml/24h • Uree – 68mg/dl • Creatinina – 2,6 mg/dl • Sediment urinar: 315 hematii/camp, cilindri hematici +

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7. Pacienta de 29 ani prezinta disurie, polakiurie, febra, frison • Proteine totale = 8,1 g/dL • Albumine = 4,3 g/dL • α1-globuline = nivel crescut • α2- globuline = nivel crescut • β- globuline = nivel crescut • γ- globuline = nivel normal • Fibrinogen = 510 mg/dL • Uree – 82mg/dl • Creatinina – 1,7 mg/dl • Osmolaritate urinara: 1007 mosm/kg • Proteine urinare – 615mg/24h • Glucoza urinara – 25mg/dl 8. Pacienta de 46 ani prezinta edeme palpebrale si gambiere, astenie, crestere ponderala • Proteine totale = 5,8 g/dL • Albumine = 3,14 g/dL • α1-globuline = nivel normal • α2- globuline = nivel crescut • β- globuline = nivel crescut • γ- globuline = nivel normal • Fibrinogen = 490 mg/dL • Proteinurie – 3,7g/24h • Diureza 2300ml/24h • Uree – 40mg/dl • Creatinina – 1,1 mg/dl • Trigliceride – 615mg/dl • Colesterol total – 411mg/dl 9. Pacienta de 21 ani prezinta frison, dureri hipogastrice, tulburari de tranzit • Proteine totale = 7,8 g/dL • Albumine = 4,1 g/dL • α1-globuline = nivel crescut • α2- globuline = nivel crescut • β- globuline = nivel normal • γ- globuline = nivel normal • Fibrinogen = 615 mg/dL • PCR = nivel crescut • VSH = nivel crescut • Uree – 34mg/dl • Creatinina – 1 mg/dl • Leucociturie = 121/mmc • Hematurie = 24/mmc • Nitriti +++ • Sediment urinar: cristale de oxalat, epitelii de tranzitie +++

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