Problem №1
Patient G., aged 14, after repeated sore throats were edema, increased volume of the stomach. In the past, suffered measles. After 5 years 1-2 times a year has strep throat. Upon admission to the state hospital moderate pallor and puffiness of face, massive swelling waist, hips, legs, feet. Belly several swollen, abdominal free fluid is determined. Diuresis 600ml. Urinalysis: beats. Weight 1024, 4.6% protein, white blood cells do not have, no red blood cells, cylinders - hyaline, epithelial, granular, in large quantities. Blood: erythrocytes 3 * 10
12
/ L, 30-40 g protein / L Hemoglobin 100 g / L, residual nitrogen 19 mmol / ll
Basophil Eosinophil Monocyte
0-1% 10%
Neutrophil
М Y
B S
Lymphocyte
0% 0% 6% 57% 23% 4%
1. What syndrome is it? (nephritic or nephrotic)
2. What could be the cause of this syndrome?
3. What laboratory data of urine and blood can be seen on this syndrome?
4. What are the main mechanism of edema with this syndrome.
Problem №2
Patient G., 30 years old, was admitted to the hospital with complaints of swelling, increased blood pressure (170/110 mm Hg. Art.), The allocation of bloody-colored urine, weakness, thirst, headache, palpitations. Complaints came two weeks after suffering tonsillitis. When you receive a state of moderate severity, skin pale, dry, swelling on the trunk and limbs, blood vessels relaxed tones, pulse 90 beats per minute. BP 175/110 mm Hg. Art. Urine output of 300 mL. Urinalysis: beats. Weight 1030-color view of "meat slops" transparency muddy, 2% protein, red blood cells - a large number, have leached, cylinders - hyaline, a large number. Blood hemoglobin 90g / l erythrocytes 3 * 10
12
/ L, residual nitrogen 33 mmol / L, 65 g protein / L (normal 65-85g / L) * 13
10
9
leukocytes / liter.
Basophil Eosinophil Neutrophil
М Y B S
Lymphocyte
0% 0% 4% 59% 25% 0% 8%
1. What syndrome is it? (nephritic or nephrotic)
2. What could be the cause of this syndrome?
3. What laboratory data of urine and blood can be seen on this syndrome?
4. What are the main mechanism of edema with this syndrome.
Monocyte
4%
Problem №3
A female patient, 43 years old, sick 12 years ago, when there was a sore throat after undergoing back pain, found in the urine protein was diagnosed with acute glomerulonephritis. Treatment was symptomatic means. Over the next 11 years, occasionally increases AD, 5 years BP 220/130 mm
Hg Found: skin pale, dry, face puffy, left border of the heart is shifted to medium - clavicular line, muted tones. 1500 ml of urine output. URINE ANALYSIS: beats. weight of 1010, 1% protein, hyaline cylinders, epitel.- a large number of erythrocytes 4-5 in Sec. of view. Leukocytes 8-9 in
Sec. Of view. Blood: erythrocytes 3.5 10
12
/ L Hemoglobin 110 g / L, 6% eosinophils, residual nitrogen 60 mmol / l (normal 65-85).
1. What kind of syndrome is it? (nephritic or nephrotic)
2. What could be causing this syndrome?
3. What is the flow of this syndrome, at what stage is it?
4. What are the laboratory data can be judged from the presence of the syndrome?

Problem №4
Patient R., 16 years old, sick for 2 years. Diagnosed with acute glomerulonephritis. 3 Months condition worsened: pale, puffy face, swelling all over the body, the left border of the heart is determined at 1 cm outside of the left mid - clavicular line in the V intercostal space, deaf tones, tachycardia, blood pressure 200/130 mm Hg Urine output of 300 mL. URINE ANALYSIS: beats. weight of 1009, 3.1% protein, hyaline cylinders, epithelial, waxy in large numbers, the red blood cells in the 10-15 n. of view., leucocytes 10-15 in Sec. of view. Blood: erythrocytes 3.2 10
12
g / l, hemoglobin 103 g / l residual azot100 -120 mmol / l. A history of frequent infections.
1. What kind of syndrome is it? (nephritic or nephrotic)
2. What could be causing this syndrome?
3. What is the flow of this syndrome, at what stage is it?
4. What are the laboratory data can be judged from the presence of the syndrome?
Problem №5
Patient G., aged 45, after undergoing at the feet of angina were massive swelling throughout the body. About 2 months treated in nephrology department about kidney disease. Discharged in satisfactory condition: edema decreased, remained moderate proteinuria, the house is not treated, the diet was not in compliance. Another sore throat accompanied by massive edema and the appearance of large amounts of protein in the urine, the daily loss which reached 102.8 In the hospital came in very serious condition. Examination revealed a sharp pallor, puffiness of the face, massive edema of the trunk and extremities. For percussion lung below IV -V edges determined blunting, voice trembling weakened. Heart sounds dull, pulse 60 per minute. BP 180/110 mm Hg
Belly several swollen, abdominal free fluid. Diuresis of 400 ml. URINE: beats. weight 1018 white
5% (albumin, globulins, fibrinogen.), white blood cells in paragraph 8-10. eyesight., erythrocytes unaltered and leached cover all n. of view., hyaline cylinders, epithelial, granular 9-10 in Sec. view
., old hyaline in Sec. of view., in polarized light found cholesterol crystals. BLOOD: Erythrocytes
3.5 × 10 12
/ L Hemoglobin 105 g / L, residual nitrogen 19 mmol / L, urea 8 mmol / l.
1. On the development of the syndrome indicate these laboratory findings and symptoms: urine protein, albumin, globulin, fibrinogen, cholesterol crystals, massive edema?
2. A sign of the syndrome is a red blood cell, pyuria, oliguria, cylindruria, anemia, increased blood pressure?
3. At what disease is possible to combine these syndromes?
4. What could be the cause of this disease?