Question

an asymptomatic female patient comes in for a physical exam and lab work. her exam is unremarkable. the results of her blood tests are all within normal limits. the urinary \dip stick\ exam reveals a trace of protein. microscopic examination of her urine reveals a few crystals. this is probably an early sign of?
a) glomerulonephrtis
b) renal calculi
c) nephrotic syndrome
d) gall stones
e) urinary tract infection

Explanation:

• Glomerulonephritis: Often presents with more significant proteinuria (not just a trace) and may have other symptoms like hematuria (blood in urine), edema, or changes in kidney function tests. Since the blood tests are normal here, it is less likely.
• Renal calculi (kidney stones): In the early stages, before the stone causes obstruction or significant damage, there can be a trace of protein (due to mild irritation or inflammation in the urinary tract) and crystals in the urine (which are precursors to stone formation).
• Nephrotic syndrome: Characterized by massive proteinuria (much more than a trace), hypoalbuminemia (low albumin in blood), edema, and hyperlipidemia. None of these other features are mentioned here.
• Gall stones: Affect the biliary system. Symptoms are related to the abdomen (right upper quadrant pain, nausea, etc.) and do not typically cause proteinuria or urinary crystals.
• Urinary tract infection: Usually presents with symptoms like dysuria (painful urination), frequency, urgency, and may have pyuria (white blood cells in urine) but not typically just a trace of protein and crystals as the main early sign.

Answer:

B. Renal calculi