The [а] the mаintenаnce phase lasts, the greater the risk fоr peоple experiencing varied emоtional states, including numbness, denial, flashbacks, grief, anger, despair, guilt, and hopelessness. Once basic survival needs are met, other needs for [b] balance and self-control emerge. People often become [c] and let down if they are unable to return to more [d] conditions. Early selfless responses to the emergency may fall away and be [e] by negative emotions and blame.
A 3 y/о femаle wаs brоught tо the pediаtrician’s office by her parents. The parents said the patient had started exhibiting tissue swelling (edema) the day before. They at first thought it was just a mild allergic reaction but decided to bring her to her physician when the problem did not go away. The patient had acute glomerulonephritis one year prior to this event. The parents said the child had “lost her appetite” and had not felt good for several days. They had also noticed that her urine had a “frothy” appearance. Pertinent laboratory tests were ordered. The laboratory scientist noted the following on the urinalysis exam: 4+ protein, 1+ blood, 2-5 fatty casts/lpf, 3-10 RBCs/hpf and occasional oval fat bodies. The patient’s serum protein level was decreased. The patient’s blood pressure was low. Routine Urinalysis Physical & Chemical Exams: Color: Yellow Appearance: milky (“frothy”) Specific Gravity: 1.035 Glucose: Negative Ketones: Negative pH: 6.5 Protein: 4+ Blood: 1+ Bilirubin: Negative Urobilinogen: Normal Nitrite: Negative Leukocyte Esterase: Negative Microscopic Exam: RBCs; 3-10/hpf WBCs; rare Squamous epithelial cells: rare Casts: 2-5 fatty casts/lpf Crystals: Neg Mucus: 1+ Bacteria: rare Miscellaneous: Occasional Oval Fat Body From these findings, what is the most likely diagnosis? (L-3)