Internal assesment 5/9/2020
1)1 Anatomical diagnosis : Renal system as decreased urine output and albuminuria ( explaining her B/L pedal edema abdominal distension and fascial puffiness : Glomerular pathology Etiological diagnosis: systemic illness Hypertension ,Diabetes causing diabetic nephropathy( nephrotic range proteinuria in a diabetic is taken as diabetic nephropathy unless otherwise proven) 2)Reason for azotemia : No hydroureteronephrosis with normal renal size and intact parenchyma with abnormal urine analysis : Hematuria and proteinuria ( glomerulonephritis /vasculitis) ? Glomerulonephritis reason for azotemia. Anemia : Looking at her peripheral smear microcytic hypochromic anemia : Iron deficiency anemia. Hypoalbuminemia: proteinuria ( because of glomerular barrier damage)causing hypoalbuminemia. Acidosis: high anion gap metabolic acidosis ( failure to excrete acids) Acute / Chronic renal failure. 3) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946919/ Chronic metabolic acidosis may have various adv