Concepts and alterations in Urinary Elimination/Renal Function

  CASE STUDY 1 A 30 year old woman recently diagnosed with rheumatoid arthritis (RA), complains of general fatigue and weight loss along with symmetric joint welling, stiffness, and pain. The stiffness is more prominent in the morning and subsides during the day. Laboratory measures reveal an RF of 120 IU/ml (nonreactive, 0 to39 IU/mL; weakly reactive, 40 to 79 IU/ml; reactive, > 80 IU/ml). Q1. Describe the immunopathogenesis of the joint changes that occur in RA. Q2. What is the significance of her RF test results? CASE STUDY 2: A 38 year old female with a past medical history significant for lupus erythematosus (SLE) and hypertension, presents to her Primary Care Physician (PCP) for a wellness visit. On physical exam, she is in no distress, VS BP 160/80mmHg (normally takes metoprolol and lisinopril but forgets from time to time) HR 80bpm RR 20/min. Laboratory results show Hgb 14g/dl, WBC 5.0k, Platelets 160K, Cr. 1.80, eGFR 48ml/min. She denies fevers, chills. Denies diarrhea. The patient is concerned about her elevated Cr and ask the PCP a few questions. Q1: Compare the etiology of Acute and Chronic Kidney Disease? Q2: Describe the mechanism for Acute Kidney Injury in Acute Tubular Necrosis.