Question

David, a 43-year-old man, arrived at the emergency room with hematuria and pain. He reported a history of kidney stones going back to when he was sixteen. His doctor at that time had told him it was a metabolic disorder. A routine urinalysis and kidney stone analysis were ordered.

Color	Amber	Clarity	Clear
Bilirubin	Negative	Nitrite	Negative
Blood	4+	pH	7.0
Glucose	Negative	Total Protein	2+
Ketones	Negative	Specific Gravity	1.010
Leukocytes	1+	Urobilinogen	2 mg/dL

Microscopic
>100 RBC/HPF
>100 WBC/HPF
0-1 hyaline casts/LPF
5- 10 granular casts/LPF
5- 10 RBC casts/LPF
Many hexagonal crystals

In your discussion board post, discuss David's results. Some items to include in your post include but are not limited to:

What metabolic disorder does this patient most likely have?

Are there typical findings for kidney stones?

What causes this disorder?

Name two related disorders

What further tests could be done?

Answer 1

Kidney disorder with stones(renal calculi) cholelithiasis is the final results with above investigations. The patient has the metabolic disorder of IBS (irritable bowel disorder) proteinuria, biliary tract obstruction as urobilinogen is 2mg/dl. The client may also be with hemolytic anemia.

The typical findings of the kidney Stones are present as the cast of WBC, rbc and granular casts/LPF is increased which shows the results of kidney stones.

The causes of renal calculi are:

# buildup of dissolved minerals on lining of kidneys may be composed of several other compounds and grow in size.

# diet it happens when the calcium and oxalate stick together when the kidneys make urine.

# gut problems like crohns disease, ulcerative colitis.

The two related disorders would be IBS (irritable bowel disorders) Crohns disease

The further tests which could be done are:

# MRI

#CT/ USG

# IVP ( intravenous pylelogram)

# retrograde pyelogram

# BUN to assess kidney function