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PATH 370 Week 5 Case Study
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lOMoARcPSD|3013804Week 5 Case Study
Pathophysiology (West Coast
University)
, lOMoARcPSD|3013804
Case 1
J.H. is a 12-year-old boy diagnosed several months ago with nephrosis following postinfectious
glomerulonephritis secondary to an episode of pneumococcal pneumonia. He has been coming
to the clinic to have his condition monitored and therapies adjusted as needed. At his latest
clinic visit, a decrease in urine output, increasing lethargy, hyperventilation, and generalized
edema are noted. Trace amounts of protein are detected in J.H.’s urine by dipstick. Blood is
drawn for laboratory analysis, and the results are as follows:
pH = 7.36
PaCO2 = 33 mm Hg
PaO2 = 100 mm Hg
HCO3 – = 18 mEq/L
Hct = 30%
Na+ = 130 mEq/L
K+ = 5.4 mEq/L
BUN = 58 mg/dl
creatinine = 3.9 mg/dl
albumin = 2.0 g/dl
Discussion Questions
1. How would a pneumococcal infection lead to glomerulonephritis? How can
glomerulonephritis result in nephrosis?
- A pneumococcal infection can lead to glomerulonephritis because the causative
agent for pneumococcal pneumonia is streptococcus pneumoniae. If the bacteria
enters the bloodstream it will circulate to the kidneys and cause inflammation of the
glomeruli which can result in damage and a decrease of function, such as a decrease
in glomerular filtration rate, (Glomerulonephritis 2020).
Glomerulonephritis can result in nephrosis, also known as nephrotic syndrome, due
to the inflammatory response that occurs in the glomerulus. Lysosomal enzymes
break down the glomerular basement membrane causing impaired functioning of
filtration. Things that are normally not able to fit through the filters, are not able to
fit because of decreased ability to filter. For example, proteins are not supposed to
be found in urine, however due to glomerulonephritis, the degree of proteinuria can
indicate nephrotic syndrome levels, (Banasik, 2021). The increased glomerular
permeability leads to proteinuria which can then lead to hypoalbuminemia,
hyperlipidemia, and hypercoagulability. Edema is also the most common finding for
nephrotic syndrome, (Banasik, 2021).
References:
Banasik, J. L. (2021). Pathophysiology (6th ed.). SAUNDERS.
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