Martha Reynolds (case #6) Tara, Sam, Amie

Case Study 6: A 60-year-old woman comes in for her annual physical Case Study 6: A 60-year-old woman comes in for her annual physical. Even though she usually has a lot of energy, she has been unusually tired for the past few weeks. She occasionally feels dizzy and she is finding it harder to sleep through the night. Her ankles and feet are swollen and her face looks a bit puffy. She frequently feels a burning pain in her lower back, just below the rib cage. She has noticed that her urine is darker in color lately. Preliminary workup shows she has elevated blood pressure. Some red blood cells are present in her urine.

Symptoms of Martha Dizzy Fluid retention Face puffy Cloudy and foul-smelling urine Burning in the lower back Tired Shortness of breath Fatigue Decreased output of urination

Possible Diagnoses Acute Kidney Failure Symptoms Decreased urination output Fluid retention Shortness of breath Drowsiness Nausea Seizures Fatigue Chest pain

Possible Diagnoses Kidney Infection (Pyelonephritis) Symptoms Back pain Fever feeling sick Confusion Blood in urine Cloudy or foul-smelling urine Pain while urinating

Possible Diagnoses Chronic Kidney Failure Symptoms Nausea Loss of appetite Fatigue and weakness Sleep problems Changes in output of urine Swelling of feet and ankles Shortness of breath

Tests The first step in ruling out possible diagnoses is by starting with a urine sample. With this test we are looking for abnormalities. There were not traces of bacteria in the urine. Therefore, kidney infection can be ruled out. The next test we would do is a urine output measurement. With this test we are looking for the amount of urine you put out in a day. This ensures that the diagnoses will be either Chronic or Acute kidney failure, and once again rules out kidney infection.

Test cont. To distinguish between chronic and acute kidney failure we looked at previous blood test results. We were looking for creatinine and B.U.N. Her levels are high, which indicates Martha has Chronic Kidney Failure. This rules out acute kidney failure due to the values being lower.

Other Body Systems Relates directly to the urinary system Cardiovascular System Skeletal system Indirectly to the digestive system

Treatments The doctors may put them on high blood pressure medicine. Reduces protein in the urine. The goal of treatment is to prevent or slow further damage. Life a healthy life style. Follow a healthy diet that is good for your kidneys.