- Phone 211 594 4000 Fax 211 594 4001 Medical Consultation Urology Date 6 25 2011 Patient Sylvia Hernandez Brow 1 (305.96 KiB) Viewed 41 times
Phone: (211) 594-4000 • Fax: (211) 594-4001 Medical Consultation: Urology Date: 6/25/2011 Patient: Sylvia Hernandez-Brown Patient Complaint: Pain in the lower lumbar region (right and left sides). The patient also complains of feeling tired, shortness of breath, general body aches with mild fever, and loss of appetite, all within the past month. History: 60-year-old Hispanic female, 40 pounds overweight with Type 2 diabetes without drug assist, history of periodic UTIS. Family History: Father deceased at 72 years old with COPD and CHF. Mother alive at 77 years with Type 2 dia- betes under care; lost one kidney at age 70 due to polycystic disease. Allergies: None Physical Examination: Vital signs: moderate fever of 99.9 °F, pulse rate 82/min., bp 129/90. Blood test reveals uremia. Urinalysis reveals albumin high, and blood in the urine. Diagnosis: Renal failure of left kidney apparent with increasing insufficiency of right kidney due to PD evident by nephrotomography and confirmed by nephroscopy. Treatment: Immediate dialysis, to repeat every other day until surgery. Admit patient for radical nephrectomy. Schedule dialysis treatments postoperative and include patient to renal transplant database. Joshua Ryan, M.D. Joshua Ryan, M.D.
After reading Sylvia Hernandez-Brown's medical chart, answer these questions: 1. What patient complaints point to the kidneys as the source of the disease? (3 points) 2. Describe the meaning of the terms nephrotomography and nephrectomy? (2 points) 3. Why does the urologist order dialysis for the patient prior to surgery? (3 points)