IPLab:Lab 5:Nodular Intercapillary Glomerulosclerosis

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Contents

Clinical Summary

This 57-year-old white male with a 25-year history of Type I diabetes mellitus (insulin-dependent ) developed an acute myocardial infarctionMyocardial infarction is necrosis of myocardial tissue which occurs as a result of a deprivation of blood supply, and thus oxygen, to the heart tissue. Blockage of blood supply to the myocardium is caused by occlusion of a coronary artery. followed by cerebral infarction, pulmonary dysfunction, and renal failureRenal failure is the severe reduction of renal function and often leads to reduced urinary output.. There was a history of hypertension and proteinuriaProtein in the urine is indicative of glomerular dysfunction.. Laboratory findings included a BUN and creatinineThese tests are measures of kidney function. High levels mean low function. of 69 mg/dLA normal BUN for this patient would be 10 to 20 mg/dL. and 3.3 mg/dLThe normal creatinine level is 0.7 to 1.3 mg/dL. which subsequently rose to 113 and 4.8, respectively. He subsequently died of multisystem failure.

Autopsy Findings

The autopsy showed the expected left ventricular hypertrophy, a large acute myocardial infarctionMyocardial infarction is necrosis of myocardial tissue which occurs as a result of a deprivation of blood supply, and thus oxygen, to the heart tissue. Blockage of blood supply to the myocardium is caused by occlusion of a coronary artery., and a large right cerebral infarction. The pancreas showed amyloidosis of the islets. There was extensive atherosclerosis and arteriolosclerosis. The kidneys were slightly enlarged, weighing 220 and 240 gramsA normal kidney weighs 157 grams (range: 115 to 220 grams). respectively, and had rough surfaces, a few cortical scars, and blurring of the corticomedullary junctions.

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