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Patient with scleroderma with acute renal failure and malignant hypertension. What will UA/blood smear show?

a) UA: Red cell casts; Blood smear: Microangiopathic hemolytic anemia
b) UA: White cell casts; Blood smear: Schistocytes
c) UA: Proteinuria; Blood smear: Howell-Jolly bodies
d) UA: Hematuria; Blood smear: Target cells

1 Answer

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Final answer:

In scleroderma with acute renal failure and malignant hypertension, the urinalysis may show red cell casts and the blood smear may indicate microangiopathic hemolytic anemia with schistocytes.

Step-by-step explanation:

In a patient with scleroderma who is experiencing acute renal failure and malignant hypertension, one might expect to see findings consistent with microangiopathic hemolytic anemia on a blood smear. Specifically, this could be evidenced by the presence of schistocytes, which are fragmented red blood cells indicative of a microangiopathic process. The urinalysis (UA) may show red cell casts suggesting glomerular disease. Thus, the correct answer would be UA: Red cell casts; Blood smear: Microangiopathic hemolytic anemia. Red cell casts in the urine point towards an underlying renal condition such as glomerulonephritis, which could be secondary to scleroderma renal crisis.

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