A 48-year-old man is evaluated for a 3-day history of increa…

A 48-year-old man is evaluated for a 3-day history of increasing confusion and lethargy. His wife urged him to seek treatment after having decreased urine output and abdominal pain for the past month. Two months ago, he was hospitalized for pyelonephritis and treated with ceftriaxone.  Medical history includes: Chronic hepatitis C Medications: None taken Vitals include: Temp 98.6*F, pulse 90/min and blood pressure 98/60 Physical exam: Appears pale and irritable. Oriented to person but not to time or place. There is scleral icterus and jaundice. 2+ pitting edema of the lower extremities. The abdomen is distended with a positive fluid wave. Laboratory studies:   Urinalysis shows no abnormalities. Fractional excretion of sodium (FENa) is < 1% Ultrasound of the kidneys is unremarkable. Intravenous fluids are administered for 36 hours but do not improve urine output. Which of the following is the most likely cause of kidney dysfunction in this patient?

There’s something that you spent time studying that wasn’t a…

There’s something that you spent time studying that wasn’t asked on this exam. What is it? Explain the pathology and investigatory/management processes associate with this to the best of your ability. Answers should be in-depth to receive full credit.

An 89 year old female is brought to the emergency department…

An 89 year old female is brought to the emergency department after losing consciousness at her nursing home. She had been watching TV for several hours and while getting up to use the bathroom, she fell and was unconscious for several seconds. She felt dizzy shortly before the fall. She does not have a headache and denies any pain.  Medical history includes: hypertension, intermittent atrial fibrillation and stable angina pectoris Medications: warfarin, aspirin, hydrochlorothiazide and nitroglycerin spray PRN Vitals: Temp 98.3*F, Pulse 100/min and regular, BP 102/56 Physical Exam: Dry tongue. Fold of skin that is pinched on the back of her hand unfolds are 2 seconds, Cardiopulmonary and Neurological exams demonstrate no abnormalities. Further evaluation of this patient is most likely to show which of the following findings?