Clinical Case Study: Renal Complications in Chronic Hypertension and Hypocalcaemia
- Subject Code :
SBI241
- University :
University of Queensland Exam Question Bank is not sponsored or endorsed by this college or university.
- Country :
Australia
SBI241
Assessment 2:
Case Study
Smith, a 47-year-old male truck driver presents to the emergency department with intractable nausea and vomiting, dyspnoea on exertion, and dizziness. The nausea began about two weeks prior to admission; vomiting has occurred within the last few days. There is no history of medication or toxin exposure. Smith has lost some weight recently and his current body weight is 52 kg. His past medical history is positive for hypertension diagnosed 14 years ago with no follow-up. He has smoked 1 packet per day for 27 years.
On physical examination, his blood pressure is 160/120 mmHg, temperature 36.7C, pulse 100/min. His skin is pale with numerous areas of bruising and excoriations. Chest x-ray shows moderate cardiomegaly with increased pulmonary vascular markings and hazy obliteration of the lower lung bases. Abdominal ultrasound examination shows a right kidney size of 7 cm and a left kidney size of 6.8 cm (normal kidney size approx. 10 cm).
Laboratory evaluation reveals:
Urinalysis |
|
Protein |
2+ |
Blood |
1+ |
Glucose |
Neg |
Casts |
Neg |
Bacteria |
Neg |
Blood report |
Reference range |
|
WBC |
6.7 x 109/L |
4.5-11 x 109/L |
Platelets |
250 x 109/L |
150-400 x 109/L |
Haematocrit |
0.29 |
0.40-0.54 (adult male) |
Creatinine |
641 umol/L |
60110 umol/L (adult male) |
Urea |
35.2 mmol/L |
3.0-8.0 mmol/L (adult) |
Calcium |
1.70 mmol/L |
2.102.60 mmol/L |
Uric Acid |
0.68 mmol/L |
0.20-0.45 mmol/L (male) |
Please answer the following TWO questions:
1a. What is the pathophysiological basis of renal changes in long-standing hypertension?
1b. How has this patient developed hypocalcaemia?
(500 words approx.)
2. Based on the clinical picture and laboratory investigations provided, what stage of chronic kidney disease this patient is in and what will be the main management approach at this stage?
(300 words approx.)
Support your answers with appropriate evidence (references). This assignment tests your ability to search scientific literature and present your answer in a scientific language. DO NOT quote lecture notes or your textbook as reference. CDU library has heaps of resources to support you. Please make full use of these helpful resources:
Tips on academic/scientific writing:
https://www.cdu.edu.au/library/language-and-learning-support/study-skills/writing
Avoiding plagiarism:
https://www.cdu.edu.au/library/language-and-learning-support/study-skills/academic- integrity
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