Case 23: Diagnostic Testing

Case 23 Index

If you could only perform one test, which would it be?
Hearing test
Not the highest yield test here, given this patient’s evaluation thus far. Pick again!
Complement levels
Complement levels are usually most helpful in patients with suspected nephritic syndromes. Though this patient has hematuria, there are other clues that suggest an alternative diagnosis.
Anti-nuclear antibodies (ANA)
Not the highest yield test in this patient. Let’s look for a more informative test!
Kidney biopsy
Not so fast! We might get into trouble if we stick a needle in this patient’s kidney. Try again!
Kidney Ultrasound
Excellent! Here it is (both kidneys appear similar) – what do you see?
Let’s wrap this up. What’s your final diagnosis?
Renal cell carcinoma
Autosomal dominant polycystic kidney disease (ADPKD)
Bladder cancer
Systemic lupus erythematosus (SLE)
Urinary tract infection
Membranous nephropathy
IgA nephropathy
Diabetic nephropathy
Hypertensive nephropathy
Thin basement membrane disease
Alport syndrome
Nutcracker syndrome

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Case 23 Index
Case 23 Introduction
Case 23 Physical Exam