82%(17)14 out of 17 people found this document helpful
This preview shows page 61 - 63 out of 143 pages.
casts, and proteinuria are discovered on urinalysis. Some patients also have hypertension. Pathophysiological mechanisms are subendothelial deposits of amorphous material that lead to vascular occlusions, mechanical RBC, and platelet damage, resulting in prothrombotic state.Alport syndrome is hereditary X-linked dominant hereditary nephritis that will also present with hematuria (asymptomatic or gross) 1-2 days after upper respiratory infection. This progressive hereditarynephritis will, however, be accompanied with bilateral sensorineural deafness and visual problems (patognomonical extrusion of central part of lenses into anterior ocular chamber).Amoxicillin side effects are not probable. Amoxicillin side effects include nausea, vomiting, rashes, antibiotic-associated colitis, and diarrhea, in addition to more rare side effects such as mental changes, lightheadedness, insomnia, confusion, anxiety, sensitivity to lights and sounds, and unclear thinking. Even allergy to amoxicillin presents with a change in mental state initially, followed by itching skin rash, fever, nausea, and vomiting any time during the treatment up to a week after treatment has stopped. Acute overdose of amoxicillin may manifest with renal dysfunction, lethargy, and vomiting, but this usually happens in very young children.Acute poststreptococcal glomerulonephritis can present with the same clinical picture: sudden hematuria, edema, and hypertension, usually together with non-specific constitutional symptoms. However, there is always a latent period between the streptococcal infection and the onset of signs and symptoms of acute glomerulonephritis. Latent period is 1-2 weeks after a throat infection and 3-6 weeks after a skin infection.Hemolytic-uremic syndrome (HUS) is acute renal failure associated with non-immune (Coombs-negative)microangiopathic hemolytic anemia and thrombocytopenia. It is the most common cause of acute renal failure in children (though it may occur in adults as well). In HUS, there is usually a prodromal gastroenteritis, fever, or bloody diarrhea for 2-7 days before the onset of renal failure, sometimes with central nervous system signs (irritability, lethargy, even seizures). Acute renal failure with anuria follows. Physical findings may reveal hypertension, edema, fluid overload, and severe pallor.A 62-year-old man is hospitalized because of a 1-week history of extreme malaise and painful skin changes. At the beginning, it was "just a rash", but it then developed into clusters of clear vesicles; new vesicles appear while old ones dry and crust over. His past medical history is significant for diabetes mellitus type II, for which he is on the diet-controlled. You find the rash distributed over his body, and
you make a diagnosis of disseminated herpes zoster. Acyclovir IV is introduced, together with the supportive therapy, but after 2 days, the patient starts experiencing nausea and swelling; his urine output dramatically decreased with laboratory studies showing elevated BUN and creatinine.