Clinical Chemistry Case Study - Proteins
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Transcript of Clinical Chemistry Case Study - Proteins
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7/24/2019 Clinical Chemistry Case Study - Proteins
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A 40-year-old Woman who
has been Feeling Lethargic
PROTEI
!ayam" !lydenne !laire P#
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$ase Problem
%&dy" a 40-year-old woman with a 'ast
history o( )idney in(ections" was seen by
her 'hysician beca&se she had been
(eeling lethargic (or a (ew wee)s# *he also
com'lained o( decreased (re+&ency o(
&rination and a bloated (eeling# The
'hysician noted 'eriorbital swelling and
general edema" incl&ding a swollen
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Laboratory Res<s,
rinalysis
Macroscopic
$olor .ellow
Appearance Cloudy or frothy
*'eci/c !raity 1#022
'3 #0Protein 3+ (500mg/dL)
(A! "+)!l&cose eg
5etones eg
6ilir&bin eg
6lood eg
robilinogen ormal
itrite eg
Le&)ocyte
Esterase
eg
Microscopic
W6$s 0-783PF
R6$s 0-183PF
E'ithelial$ells
Rare s+&amo&s83PFRare renal t&b&lar
e'ithelial83PF$asts 0-7 3yaline8LPF
1# Renal T&b&lar
e'ithelial83PF
2# !ran&lar8LPF
7# Wa9y8LPF
0#$ %atty/LP%
Other &ccasional o'al fat
odies
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Laboratory Res<s, $hemistry
eference ange
Protein :#0 g8dL ;#0-
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1#What ty'e o( disease or
condition wo&ld becharacteri>ed by the&rinalysis and chemistry
res<s?
*ephrotic syndrome mar)ed 'rotein&ria and li'id&ria
@oal (at bodies and (atty casts in&rinalysis
3y'oalb&minemia and
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2# Bisc&ss the 'hysiological ca&se o(edema#
dema
ca&sed by hy'oalb&minemia
which leads to red&ced'lasma osmotic 'ress&re@allows C&id to lea) (rom
blood essels to the intestinals'aces#
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7# What is %&dyDs alb&min,glob&lin @A,!ratio? Is it within the re(erence range? Is
it consistent with the 'robable diagnosis?
%&dyDs A,! ratio is 0,-." which is belowthe re(erence range @1#:-7#:# ormalalb&min leels are ;0 o( the total'rotein# A low A,! ratio is consistent witha diagnosis o( ne'hrotic syndrome#Total *er&m Protein Alb&min G !lob&lin! TP - A
! :#0 g8dL H 2#4 g8dL 2#; g8dLA,! 2#4 g8dL , 2#; g8dL
A,! 0#2
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4# Bescribe what yo& wo&ld e9'ectto see in this 'atientDs 'roteinelectro'horesis#
*ephrotic yndrome P mar)edly increase in J2- and K-
glob&lins
mar)edly decrease alb&min and-glob&lins" es'ecially Ig!