Havana/ Keannu E.

MLS3B
Case
A 31 year old female was rushed to the ER due to her complains of shortness of
breath/ fatigue & weakness/ hypertension/ vomiting and cough. The patient also
complained that she has recently been losing weight. Upon admission, her doctor
requested for Chemistry test. The following are the results obtained:
Clinical Microscopy Test Results
Urine Examination
Physical Examination
Appearance Cloudy
Color Yellow
Urine Chemistry
Protein 2+
pH 5.5
SG 1.024
Glucose Negative
Microalbumin 150/ 3+
Urine Bilirubin Negative
Urine Urobilinogen 17.0 Normal
Nitrite Negative
Leukocyte Esterase Trace - ca.15
Urine Ketone Negative
Clinical Microscopy Test Results
Urine Flow Cytometry
Normal Value
RBC 364 /uL 0 -28 /uL
Uniform RBCs
WBC 134 /uL 0 – 27 /uL
Epithelial Cells 33 /uL 0 – 7 /uL
Cast 0 /uL 0 – 2 /uL
Bacteria 7727 /uL 0 - 111 /uL

Blood Chemistry Test Results

Normal Value
Blood Urea Nitrogen 54.22 mmol/L 2.9 - 7.1
Creatinine 460.94 umol/L 39.0 - 113.0
Serum Magnesium 1.24 mmol/L 0.74 - 1.03
Sodium 130.68 mmol/L 136.0 - 144.0
Calcium 1.82 mmol/L 1.75 - 2.39
Potassium 6.46 mmol/L 3.6 - 5.1
- Serum is icteric. Rechecked done to validate result.
Guide questions:
1. What is the diagnosis of the patient? Justify your answer by pointing out the
part in the case which leads you to the diagnosis.
Her symptoms/ which include trouble breathing/ coughing/ exhaustion/ and weakness/ are
consistent with an infection. A physical examination also indicates that the clarity
is unclear/ which might be due to germs. This theory is linked to bacterial
infection. The chemical study found aberrant amounts of protein and microalbumin/
which might be suggestive of glomerular dysfunction. Elevated RBC levels have also
been linked to glomerular dysfunction. Furthermore/ an increase in WBC/ bacteria/
and epithelial cells in the urine significantly supports the diagnostic and physical
examination. The patient,s high white blood cell count/ urine pH/ and the presence of
bacteria are all compatible with cystitis, leading to the diagnosis of acute
glomerulonephritis. As well as markers of electrolytes and trash that was not entirely
filtered and expelled/ which is one of the duties of the glomerulus. Streptococcus
group A is the microorganism involved.
2. Explain the pathophysiology of the disease.
Pathophysiologic issues caused by the rapid onset of acute glomerulonephritis/ also
known as acute nephritic syndrome/ include changes in the rate of glomerular
ultrafiltrate formation/ abnormal glomerular capillary wall permeability to plasma
proteins and erythrocytes/ and modifications in the kidney,s salt handling. The
ultimate indications include water edema/ arterial congestion/ and elevated systemic
arterial pressure. The clinical appearance/ severity/ and particular anomalies of
these disturbances vary greatly amongst patients. Furthermore/ it frequently occurs
with a sickness caused by Streptococcus streptococcal group B strains. Cystitis/
often known as interstitial cystitis/ is the most common bladder ailment. If not
treated, this might develop to a more serious higher UTI. When bacteria grow and
thrive in the bladder/ they may eventually reach the infectious threshold required to
cause sickness. Babies and their moms are especially sensitive to this disease. If
the bladder infection is not treated/ urine will run backwards up the urethra and
into the kidney/ where it might develop Pyelonephritis.
3. What are the laboratory test
a. Anti-group A streptococcal enzyme test
b. BUN
c. For Cystitis: Urine culture