1. A 30 year old femal patient presented in the emergency department with 60% burns and musculoskeletal injuries. The patient was stabilized in the surgery department and a blood sample was sent for routine investigations. After 36 hours of admission, surgeon advised measurement of 24 hours urine output. Scenario 1 The patient responded to treatment and showed gradual improvement in health after 5 days of intensive care.

2. Question 1) what is the probable etiology in this case? 2) Enumerate clinical features? 3) Explain pathophysiology for the same? 4) Enumerate investigations advised in this case? 5) Enumerate biochemical investigations ? 6) Enumerate biochemical agents whose levels will be elevated? And why? 7) What will be your Diagnosis in this case?

3. 8) How you will treat this patient? Scenario 2 The 24 hour urine report showed urine volume < 300 ml and presence of myoglobin in urine. The patient was managed aggressively and after 3 days her urine output increased suddenly to 3000 ml in 24 hours. Patient recovered in another 4-5 days. 1)What is pathophysiology in this scenario? 2)What will be the diagnosis in this case?

4. 3) what is the reason for oliguria and diuresis? 4) If patient had died and autopsy was performed. Enumerate histopathological features of renal tissue?

5. A 75 year old male patient presented in the out-patient department with vomiting, thirst, irritability,decreased urine output an azotemia. Medical history of patient revealed daily consumption of ACE inhibitors and insulin since past 10 years. 1)What is the diagnosis? 2) What is the etiology ?

6. What is the pathophysiology in this case? What is azotemia and uremia? Enumerate clinical features of uremia? How you will investigate this patient? Enumerate treatment modalities ?