And so, a happy ending.
It always makes me smile to see things work out.
One.
Tune in next time when we find out if this will be old dotty great aunt Bedelia’s only stop…
I think I misspoke in class the other day. I’m not positive, but I may have used the term Oligouria incorrectly.
Regardless of what I may have said, I want to clarify here…
Oligiouria is the condition of producing small amounts of urine. Oligo- meaning ‘small, little’ + -uria, from the Gr. Ouron = urine. Clinically, oligouria is defined as the production of 100-400 ml of urine per day as opposed to the typical 400 to 2,000 mL — from about 2 liters of fluid intake.
Less than that and you’re in the realm of Anuria (a- meaning ‘no’ + -uria).
Decreased urine production can be caused by a number of conditions, but most commonly, it is an indicator of dehydration or hypovolemic shock, which may also sequelae of a variety of things. Hiking in the desert without water can do it, but so can kidney failure or a blockage – both of which can occur even with adequate hydration.
The other end of the spectrum is Polyuria, or the production of excessive urine ~more than 2.5 Liters over the course of a 24 hr day. This is essentially equivalent to Diuresis which is from the Gr. Diourein, meaning ‘to urinate’.
A 25 yo man presents at the ER with abrupt, intense pain in the right flank and ipsilateral lower abdomen. In addition to abdominal pains, he also feels pain in the right testicle and has had to urinate frequently and always with pain. Imaging was done to aid in assessment.
Given this information, what diagnosis might you suggest? Explain the symptoms and what is revealed by the imaging. What treatment do you suggest?
As always, I invite students and non-students to submit multiple choice questions appropriate for the upcoming exam on the Renal System (Physiology and Pathophysiology questions). Post questions with answers (three wrong and one right) in the comments section below.
Also, here’s an opportunity for two points of extra credit on the upcoming exam:
Submit your answer quick – only the first correct response (also posted in comments) earns points. I will try to post several more questions over the weekend – note, these extra credit vignettes may come from any of the chapters we studied this semester)
Presentation
A 62 year old man presented at the ER with sudden sensation of food being caught in his throat while swallowing. The patient is highly agitated and convinced he is choking although he appears to be getting air.
An emergency endoscopy reveals food stuck in the esophagus. With pressure, food bolus passed into the stomach successfully. A subsequent barium swallow and X Ray produced the image here.
What is the diagnosis?