A 41-year-old man presents at an office for a regular health check-up. He has no complaints. He has no history of significant illnesses. He currently takes omeprazole for gastroesophageal reflux disease. He occasionally smokes cigarettes and drinks alcohol. The family history is unremarkable. The vital signs include: blood pressure 133/67 mm Hg, pulse 67/min, respiratory rate 15/min, and temperature 36.7°C (98.0°F). The physical examination was within normal limits. A complete blood count reveals normal values. A urinalysis was ordered which shows the following: pH 6.7 Color light yellow RBC none WBC none Protein absent Cast hyaline casts Glucose absent Crystal none Ketone absent Nitrite absent Which of the following is the likely etiology for hyaline casts in this patient?
AEnd-stage renal disease/chronic kidney disease (CKD)
BAcute interstitial nephritis
CNon-specific; can be a normal finding
DPost-streptococcal glomerulonephritis
ENephrotic syndrome
A 43-year-old man comes to the physician for a 1-week history of swelling around his eyes and decreased urination. His pulse is 87/min, and blood pressure is 152/95 mm Hg. Physical examination shows 1+ periorbital and pretibial edema. Serum studies show a urea nitrogen concentration of 21 mg/dL and a creatinine concentration of 1.4 mg/dL. Urinalysis shows 3+ blood and 1+ protein. Further evaluation of this patient is most likely to show which of the following?
AUrinary rhomboid crystals
BRenal interstitial inflammation
CHypoalbuminemia
DDetached renal tubular epithelial cells
ERed blood cell casts
A 62-year-old woman with type 2 diabetes mellitus comes to the physician because of a 3-month history of fatigue and weakness. Her hemoglobin A1c concentration was 13.5% 12 weeks ago. Her blood pressure is 152/92 mm Hg. Examination shows lower extremity edema. Serum studies show: K+ 5.1 mEq/L Phosphorus 5.0 mg/dL Ca2+ 7.8 mg/dL Urea nitrogen 60 mg/dL Creatinine 2.2 mg/dL Which of the following is the best parameter for early detection of this patient’s renal condition?
ASerum total protein
BSerum creatinine
CUrinary red blood cell casts
DSerum urea nitrogen
EUrinary albumin
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