TY - CHAP M1 - Book, Section TI - Patient with Acute Kidney Injury - Case 3 A1 - Esquivel, Ernie L. A2 - Stern, Scott D.C. A2 - Cifu, Adam S. A2 - Altkorn, Diane PY - 2020 T2 - Symptom to Diagnosis: An Evidence-Based Guide, 4e AB - PATIENT Mrs. F is a 63-year-old woman with a history of diastolic dysfunction, hypertension, and knee and hip osteoarthritis. Her usual medications are atenolol, lisinopril, and acetaminophen, and her baseline serum creatinine is 1.1 mg/dL. Four weeks ago, she came to your office with severe pain, erythema, and swelling of her right first metatarsophalangeal joint.You diagnosed gout and prescribed indomethacin 25 mg 3 times daily until the symptoms resolved. She returned for a follow-up yesterday, reporting that the gout had resolved in a few days, but that she kept taking the indomethacin because it also relieved her chronic knee and hip pain. Despite your reservations, you agree to refill the prescription because she clearly feels so much better than usual, cautioning her to use the medication only when she needs it. Today you receive the results of the blood tests you ordered during the visit: Na, 141 mEq/L; K, 5.0 mEq/L; Cl, 100 mEq/L; HCO3, 20 mEq/L; BUN, 32 mg/dL; creatinine, 2.5 mg/dL.At this point, what is the leading hypothesis, what are the active alternatives, and is there a must not miss diagnosis? Given this differential diagnosis, what tests should be ordered? SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/09/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1185666771 ER -