Styles Part 3 of 5 -Renal Case 3A physician would like to prescribe a nephrotoxi
ID: 123696 • Letter: S
Question
Styles Part 3 of 5 -Renal Case 3A physician would like to prescribe a nephrotoxic antibiotic for a 60-year-old man weighing 80 kg. The patient has a serum creatinine level of 0.9 mg/dl. Question 6 of 14 How can the physician determine whether it is safe to prescribe this medication before the patient leaves the office? A. Collect a timed 30-minute urine sample. B. Perform an albumin: creatinine ratio. C. Calculate the eGFR using the Cockcroft and Gault formula. D. Perform a routine urinalysis.Reset Selection Question 7 of 14 Can the medication be prescribed for this patient with a reasonable assurance of safety? A. Yes, the clearance is 98 mL/min in a 60-year-old man. B. Yes, the clearance is 89 ml/min in a 60-year-old man. C. No, the clearance is 59 mL/min in a 60-year-old man. D. No, the serum creatinine is not normal. Question 8 of 14 A creatinine clearance was also performed for the patient with the following results: serum creatinine: 0.9 mg/dL, urine creatinine: 100 mg/dL, 24-hour urine volume 720 mL. Should the patient have been given the medication or not? A. Yes, the clearance is the same as the calculated result. B. No, the clearance is the same as the calculated result. C. Yes, this clearance is 101 ml/min. D. No, this clearance is 56 mL/min.Explanation / Answer
Question 6 of 14.
Glomerular filtration rate is the best way to measure the kidney function and to plan treatment according to that. Antibiotics with Nephrotoxic potential should be avoided or used with extreme caution in patients with kidney disease. In general, eGFR should be greater than 60ml/min/1.73m2.
OPtion B is correct. Calculate the eGFR using Cockcroft and Gault formula.
Question 7 of 14.
Calculation of creatinine clearance using Cockcroft and Gault formula is
(140-age in years) *weight in kg/ 72* serum creatinine
(140-60)*80/ 72*0.9 = 98.7
Patient GFR is 98.7mL/min. This shows kidney damage with normal kidney function as the GFR is greater than 90mL/min. So the medication should be prescribed with reassurance to the patient.
Option a is correct. Yes, the clearance is 98mL/min in a 60-year-old man.
Question 8 of 14.
Calculation of creatinine clearance
Volume of urine (mL/min) * urea creatinine( mg/dL)/ serum creatinine mg/dL
0.5mL/min *1oomg/dL / 0.9 = 55.5
The creatinine clearance is 55.5mL/min.
Option D is correct. No, the clearance is 56mL/min.