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Elderly female with osteoporosis, diabetes mellitus 2, and hypertension.…
Elderly female with osteoporosis, diabetes mellitus 2, and hypertension. She noticed blood in her urine.
Hypertension:could lead to renal failure if the glomerulus or the small blood vessels in the kidneys are destroyed, which cannot regenerate.
Osteoporosis:her condition may be linked to an increase of phosphate elimination via urine, which causes a decrese in the formation of calcium phosphate and therefore a decrease in redeposited calcium in the bone and an increase in blood calcium levels.
Her phosphate excretion imbalance could perhaps be due to an underlying parathyroid hormone problem. Since PTH regulates the amount of calcium and phosphate in the urine and within the blood.
Diabetes Mellitus II: can lead to glucosuria which occurs when there is an increased level of sugar in the blood and it exceeds the transport maximum by the proximal convoluted tubule. Glucose molecules act as an osmotic diuretic, pulling water into the tubular fluid and causing additional loss of fluid in the urine. Diabetes mellitus can also lead to *renal failure.
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Nephrons: are the functional filtration unit of the kidney. They are composed of a renal corpuscle, a proximal and distal convoluted tubule, and nephron loop.
Cortical Nephrons: are more abundant in the kidneys than juxtamedullary nephrons. They have their renal corpuscles located in the cortex and their short loop slightly penetrating the the medulla.
Juxtamedullary Nephons: with only 15% of the nephrons being this type, they are the least abundant in the kidneys. Their renal corpuscles lie adjacent to the corticomedullary junction and their loop is longer extending deeper into the medulla.These nephrons establish a salt concentration gradient within the interstitial space that lies outside the nephron loop, the collecting tubules and ducts, therefore allowing for the regulation of urine concentration by antidiuretic hormone (ADH).
Glomerular Filtration: is the passive separation of water and solutes from the blood plasma within the glomerular capillaries.
Tubular Reabsorption: occurs when componets within the tubular fluid move from renal tubules, collecting tubules, and cillecting ducts across their walls and return to the bloof within the peritubular capillaries and vasa recta.
Tubular Secretion: is the movement of solutes out of the blood within the peritubular and vasa recta capullaries into the tubular fluid. Mosr substances are secreted in the proximal convoluted tubule.
Substances Reabsorbed Completely: include nutrients in the proximal convoluted tubule (PCT). Proteins is transported from the tubular fluid back into the blood.
Substances with regulated reabsorbtion: include Na, K, HCO3, Ca, and water.
Substances eliminated as waste products: include urea, uric acid, and creatine.
Osteoporosis: is a decease that results in decreased bone mass and leads to weakened bones that are prone to fracture.
Diabetes Mellitus II: results from either decreased insulin release or decreased insulin effectiveness at peripheral tissues. It is a metabolic condition due to inadequate uptake/absorption of glucose from the blood. This can lead to glucosuria which is excess urine being filtered through the urine.
Hypertension: is chronic high blood pressure, that may damage blood vessel walls. It also places an extra work load on the heart that can lead to congested heart failure.
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Hematuria: is blood (erythrocytes) in the urine. This could be due to glomerular damage, kidney trauma, or pathology along the urinary tract.
Her hypertension could be the reason behind the blood in her urine, if it has damaged the glomerulus or small blood vessels in her kidneys.
The treatment for hematuria would depend on what is causing the blood to be excreted in the urine. If she does not get this taken care of my guess is that her kidneys will eventually fail. Given her medical history her kidneys are already under a lot of stress.