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Caso Clínico Nefro

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by

Blanca Tarragón

on 18 October 2013

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Transcript of Caso Clínico Nefro

Anamnesis
Varón, 61 años
HTA
Cardiopatía isquémica
MEG, anorexia, pérdida de 10 kg en 5 meses
Dolor epigástrico de 1 mes
Dolor osteomuscular crónico
Amlodipino
Bisoprolol, Atorvastatina
Paracetamol
PA 90/60 mmHg
FC 90 lpm
Sequedad cutáneo-mucosa
Auscultación cardiopulmonar normal
No edemas
Dolor a la palpación en epigastrio y mesogastrio

Exploración física
Analítica
Retirada de hipotensores
Eco abdominal
Hidratación con SF 100 ml/h
Hemodiálisis
Biopsia
Anuria y empeoramiento K
Mejoría electrolitos
IgG
kappa
Medulograma
Tratamiento
Hemodiálisis
Fallece a los 9 meses
Manejo inicial
Mieloma Múltiple
Insuficiencia Renal
Aguda
Obstrucción tubular
Lisis
tumoral
• Quimioterapia
• Bifosfonatos
• Radiación
• Cirugía
• Terapia biológica
• TPH
• Plasmaféresis
Restaurar volemia
Disminuir Ca sérico
Disminuir resorción ósea
Hemodiálisis
IR
MM
Pronóstico
¡Gracias!
Hipovolemia
Caso Clínico 5
Nicolás Sierrasesúmaga
Alba Soto
Blanca Tarragón
Paula Tellechea
Pilar Toledano
Sandra Toro
Hipercalcemia
Plasmocitoma
Esplenomegalia
Full transcript