FUCKING POOR NEFROS

PRESENTATION OF 27D

POOR NEFROS
Nefros, 15 years old, came to the public health center with some complaints, like hurt when pisses and got fever since three days ago. From the anamnesis known that since two months ago nefros had had bulge at his legs and bubbled urine from the physical examinations known that general health status had been in average condition, blood pressure 110/70 mmHg, body temperature at 38C. From the abdominal examinations, known that nefros had got ascites supra symphysis pressure pain, bulge extremity +/+. Laboratory checkknown that Hb 11gr/dL, leukocyte 14.000mm, albumin urine ++++, leukocyte sediment 20-30/LPB doctor suggested to send nefros to hospital because he got leaked kidney, beside of urinary tract infections. At hospital, a laboratory check had been done. With results total cholesterol 800mg/dL, albumin serum 1,2 gr/dL, esbach 4gr/dL. From urine culture known the result as E.coli with more than 100.000 colony /ml urine. how do you explain about what happened to nefros?

terminology
Ascites : fluid in peritoneal Esbach : a test that used to measure the number of urine protein, for the purpose of evaluating the kidneys functions

problems
Why nefros got disuria and fever? Was there any connection between age and sex of nefros with his complaints? Why nefros got bulge legs and bubled urine? Was there any connection between the past and present of nefros complaints? What was the interpretations of physical examination? What was the interpretations of laboratory check? Why did doctor diagnose nefros with urinary tract infection and kidney disorder? What was the interpretations of the laboratory check at hospital? what is the cause of kidney disorder? What was the indications to send nofros to hospital?

Analysis
1. Why nefros got disuria and fever? Disuria can be caused by trauma, urolithiasis, and infections. And infections can cause fever. 2. Was there any connection between age and sex of nefros with his complaints? in childhood the frequency of urinary tract infection is high in males, but as human grows up, the frequency of the urinary tract infection is high in females, because female got shorter urethra than males.

3. Why nefros got edema and bubbled urine? edema can be caused by the increase of the bodys fluid volume, the increase of hydrostatic pressure and the decreased osmotic pressure. Bubbled urine can be caused by proteinuria

4. Was there any connection between the past and present of nefros complaints? proteinurian can cause globulin to be excreted, and this condition can lead the weaken of the immune system, and cause infections.

5. What was the interpretations of physical examination? blood pressure 110/70 mmHg hypotension, caused by the decrease of onkotic pressure, causing the bodys fluid to leave the intravascular bodys temperature 38C - fever, caused by infection ascites caused by the decrease of onkotic pressure, causing the bodys fluid to enter the interstitial space and peritoneal pain at supra symphysis infection in urinary bladder

6. What was the interpretations of laboratory check? Hb 11 gr/dL normal for juvenile leukocyte 14.000/mm - infection urine albumin ++++ - >2000mg leukocyt sediment 20 -30 LPB piuria

7. Why did doctor diagnose nefros with urinary tract infection and kidney disorder? urinary tract infection piuria, fever, pain at supra symphysis kidney disorder- edema, bubbled urine, albumin urine ++++

8. What was the interpretations of the laboratory check at hospital? cholesterol 800mg/dL high, caused by hypoalbuminemia esbach +4 proteinuria bacteria culture >100.000 - infection

9. what is the cause of kidney disorder? most likely can be caused by auto immune 10. What was the indications to send nofros to hospital? kidney disorder

Learning objective
1. Urinary tract infections 2. glomerulopathy