Laboratory results summary:

Haemoglobin 7.0 g/dL 11.8 – 16.3

Serum urea 47 mmol/L 3.3 – 6.7

Serum creatinine 900 µm/L 60 – 120

Potassium 6.6 mmol/L 3.6 – 5

Serum calcium 2.0 mmol/L 2.2 – 2.56

Alkaline phosphate 205 IU/L 30 – 90

Parathyroid hormone 86 pg./mL 10 – 65

Arterial Blood gases:

pH 7.21 7.35 – 7.45

PaO2 90 mmHg 80 – 100

PaCO2 29 mmHg 35 – 45

HCO3- 12 mmol/L 22 – 30

Prostate Specific Antigen (PSA) 15.5 mg/ml <4

Chest X – Ray: showed cardiomegaly and congested lung fields.

X-rays showed decreased bone density.

Cardiac ultrasound revealed cardiomegaly, with a small pericardial effusion. Myocardial

contractility was good with left ventricular hypertrophy.

Trans-rectal and upper abdominal ultra-sound scan report:

Prostate was uniformly enlarged. The bladder was dilated and full. The ureters were dilated
and there was mild bilateral hydro-nephrosis.
Tasks

14. Explaining the findings above and relate to history and physical examination.
15. List Mr Matyaba’s problem.
16. For each problem listed, outline the principles of management to this patient.