A 55 Year Old Ranch Hand Who Complains Of Puffy Eyes Complains Of Puffy Eyes Tired And Achy Thinks He Has A Low Grade 1 (707.68 KiB) Viewed 36 times
A 55 year-old ranch hand who complains of puffy eyes. Complains of puffy eyes. Tired and achy, thinks he has a low-grade fever. Says two days ago his urine turned dark brown and has stayed that way. - Three weeks ago, while mending fences, he scratched his right leg and developed a skin infection that required antibiotics. He says at that time he developed red streaks up his leg, leading from the area of infection. BP 156/94, Temp=99.2 Physical Exam Figure 1: Control on left, Patient on right Chemical Exam Bayer Bayer AD PRODUCT INSERTBEFORE TESTS AND READING TIME LEUKOCYTES NEGATIVE 2 minutes NITRITE 60 seconds UROBILINOGEN 0.2 60 seconds PROTEIN 60 seconds pH 60 seconds BLOOD 60 seconds SPECIFIC GRAVITY 45 seconds NEGATIVE KETONE 40 seconds NEGATIVE 5.0 NEGATIVE 1.000 NEGATIVE NORMAL BILIRUBIN NEGATIVE 30 seconds GLUCOSE NEGATIVE 30 seconds 1 TRACE 6.0 TRACE Y.E NON-HEMOLYZED 1.005 mg/dL g/dL (%) mg/dl mg/d. mg/dL URINE (1 mg approx. 1 EU) 2 6.5 MODERATE 28-3 SPOR 1.010 TRACE 5 TRACE 1/10 (tr.) 100 30 7.0 HEMOLYZED TRACE 1.015 SMALL 15 SMALL 1/4 250 100 7.5 SMALL 1.020 MODERATE SMALL 1/2 500 MODERATE -POSITIVE (any degree of uniform pink color) 300 8.0 MODERATE 1.025 80 MODERATE 1 1000 -LARGE- LARGE +++ 2000 or more ++++ 8.5 LARGE +++ 1.030 160 LARGE +++ 2 or more 2000 or more
1. Record the physical, chemical, and microscopic results. 2. Determine the most likely pathogenic condition. 3. Explain how the patient's history and laboratory results correlate with the selected condition.
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