Match each clinical presentation of a nephrologic or urologic emergency with its most appropriate targeted intervention.
- A 68-year-old male with end-stage renal disease misses two hemodialysis sessions. He presents with generalized weakness, a serum potassium level of 8.1 mEq/L, and an electrocardiogram demonstrating a sine-wave pattern.Intravenous administration of calcium gluconate
- A 35-year-old female treated with lithium for bipolar disorder presents with severe polyuria and a serum sodium of 152 mEq/L. Urine osmolality is 120 mOsm/kg and remains unchanged after the administration of exogenous desmopressin.Initiation of amiloride therapy
- A 50-year-old male is extricated from a collapsed building after 12 hours. He has swollen, tense lower extremities, tea-colored urine, and a serum creatine kinase of 45,000 U/L.Aggressive intravenous hydration with isotonic crystalloids
- A 70-year-old male with a known history of benign prostatic hyperplasia presents with severe suprapubic pain, agitation, and an inability to void for the past 18 hours. A tender mass is palpated in the lower abdomen.Immediate placement of a urethral catheter
Answer
The missed dialysis patient requires calcium gluconate; the lithium toxicity patient requires amiloride; the crush injury patient requires aggressive hydration; and the prostatic hyperplasia patient requires a urethral catheter.
Each clinical scenario requires a specific, targeted intervention based on the underlying pathophysiology of the nephrologic or urologic emergency, ranging from membrane stabilization to mechanical obstruction relief.
Step-by-Step Solution
Key Concept
Targeted management of nephrologic emergencies relies on identifying the primary pathophysiologic insult, such as membrane instability in hyperkalemia or tubular toxicity in rhabdomyolysis.
Estimated Time:1m 30s