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The presence of epithelial cells in urinary casts indicates which of the following pathophysiologic conditions?

A.

Acute tubular necrosis

B.

Glomerulonephritis

C.

Urinary tract infection

D.

Pyelonephritis

Answer and Explanation

The Correct Answer is A

A. The presence of epithelial cells in urinary casts is indicative of acute tubular necrosis (ATN), a condition where the tubular cells in the kidneys are damaged, often due to ischemia or nephrotoxic substances. These damaged cells shed into the urine, forming casts.  

B. Glomerulonephritis is characterized by inflammation of the glomeruli and typically leads to hematuria and proteinuria, but it is not specifically associated with epithelial cells in casts.  

C. Urinary tract infections (UTIs) usually cause bacteriuria, pyuria, and sometimes hematuria, but not epithelial cell casts.  

D. Pyelonephritis is an infection of the kidneys that can cause white blood cell casts and bacteria in the urine, but it is not typically associated with epithelial cell casts.  


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Related Questions

Correct Answer is B

Explanation

A. Immunodeficiency does not directly cause endocrine disorders, although some immune system issues can affect endocrine function, such as in autoimmune diseases.

B. Adenomas (benign tumors) are the most common cause of endocrine disorders, as they can overproduce hormones or disrupt normal gland function, leading to conditions like hyperthyroidism or Cushing's disease.

C. Surgical removal of endocrine glands may cause endocrine disorders, but it is a result of treatment rather than a common cause.

D. Infection can lead to endocrine disorders, particularly in cases of infectious diseases affecting specific glands (e.g., thyroiditis), but it is not the most common cause overall.

Correct Answer is D

Explanation

A. A platelet count of 150,000/mm is within the normal range (150,000-450,000/mm), and while platelet count can be important in assessing for bleeding risks, it is not the most urgent value in the context of HIV.

B. A positive Western blot test confirms HIV infection but is not an acute or urgent finding. It is used for diagnosis, and the priority is to manage the ongoing health of the patient.

C. A WBC count of 5,000/mm is within the normal range (4,000-11,000/mm), so this is not an alarming value.

D. A CD4-T-cell count of 180 cells/mm is significantly low. CD4-T-cell count is a critical marker of immune function in HIV patients. A count below 200 cells/mm indicates a severely compromised immune system and places the patient at high risk for opportunistic infections. This is the most urgent value and requires immediate attention.

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