Case Study 3: Patient J.O., currently 42 years of age, consulted our practice seeking additional information about and o

[answerhappygod]

Case Study 3 Patient J O Currently 42 Years Of Age Consulted Our Practice Seeking Additional Information About And O 1 (77.01 KiB) Viewed 136 times

Case Study 3 Patient J O Currently 42 Years Of Age Consulted Our Practice Seeking Additional Information About And O 2 (27.95 KiB) Viewed 136 times

Case Study 3: Patient J.O., currently 42 years of age, consulted our practice seeking additional information about and optimal care of her rare kidney stone disorder. At the time of presentation, she had a long and complicated medical and kidney stone history. Patient was hospitalized upon urgent referral from doctor's office. Urinalysis was performed Test Patient Result Reference Range Color Yellow Clarity Cloudy Glucose Neg Negative Ketones Neg Negative Bilirubin Neg Negative Sp.Gravity 1.005-1.030 Blood Negative pH 5.0-8.0 Protein Negative Urobilinogen Nitrite Neg Negative Leuk. Estrase Negative RBC WBC 51-100 None Epithelial cells Hyaline Cast Negative Bacteria Crystals Cystine 1+ Negative 1.021 2+ 7.5 1+ 1.0 0.2-1.0 3+ 11-24 0-3 0-5 57 <10 1 1+ Past History: At the age of 13 years, she had sudden onset of sharp pain in her back and lower abdomen that worsened over a short period of time. She described an inability to find a comfortable position, nausea, vomiting, and intense sweating, and was brought to the emergency room with concern for ruptured appendicitis. In the emergency department, an abdominal X-ray revealed a right- sided ureteral stone 4 mm in diameter. She was told to take pain medication and was sent home for the stone to pass and be collected. J.O.'s pain resolved, presumably representing passage of the stone. However, the stone was not recovered. She remained without incident until age 22, when she presented to the emergency department with the same symptoms as in the previous episode. The stone was collected and sent to the appropriate laboratory to determine its composition by X-ray crystallography. The stone composition was 100% cysteine.
1. How does the patient's current renal problems relate to the cysteine crystals found? 2. What laboratory tests are performed to confirm the presence of cysteine crystals in the urine? 9. What are the long term effects of cysteine crystal formation? 4. Are there treatments available for patients with cystinuria?