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A beforehand wholesome 14-year-old woman presents with 2 weeks of malaise and irregular laboratory outcomes. She offered to her pediatrician 1 week in the past with fever and fatigue and acquired amoxicillin for culture-positive streptococcal pharyngitis. Nevertheless, she had no enchancment and started having each day episodes of nonbloody, nonbilious emesis. Sooner or later in the past she famous decreased urine output, facial puffiness, and delicate stomach distention. Presently, she experiences no complications, epistaxis, sinusitis, or respiratory signs.
On bodily examination, she is afebrile, with a coronary heart fee of 78 beats/min and blood strain of 149/85 mm Hg. She seems effectively, with regular bodily findings besides delicate facial and decrease extremity edema and delicate stomach distention.
Preliminary laboratory outcomes are:
Electrocardiography reveals regular sinus rhythm with out peaked T waves. Kidney ultrasonography exhibits enlarged, barely echogenic kidneys.
Dialogue – “creatinine 5.7”
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“creatinine 5.7”