Case 25: Diagnostic Testing Cont’d…

Case 25 Index

Take a look at some basic labs below.
Basic labs
What’s the next best test to diagnose the etiology of this patient’s presentation (choose 1!)?
Complement levels
Not the best test here, we don’t evidence of nephritic syndrome or immune complex mediated disease. Try again! 
Kidney biopsy
Ouch! Not a good idea here. Pick again!
24 hour urine collection for creatinine clearance measurement
This test is helpful in patient’s in whom estimated glomerular filtration rate (GFR) calculations may be inaccurate. A more accurate GFR value won’t help us right now. Try again!
Urinalysis and urine electrolytes
Excellent! Here they are:
Position emission tomography (PET) scan
Though this test may be help to evaluate for metastatic disease in this patient, there is a better test to diagnose the etiology of his current presentation. Pick again!
It’s time to lock in your final diagnosis below. Pick one!
Salicylate toxicity
Diabetic ketoacidosis
Acetaminophen toxicity
Alcoholic ketoacidosis
Surreptitious laxative use 
Type 1 RTA
Type 2 RTA
Type 4 RTA
Surreptitious diuretic use
Lactic ketoacidosis
Ethylene glycol poisoning
Vomiting due to chemotherapy 

Almost there – let’s finish up this case

Case 25 Index
Case 25 Introduction
Case 25 Physical Exam
Case 25 Diagnostic Testing