A 42-Year-Old Woman Undergoing a Renal Transplant Evaluation

Heather Kesler DeVore, MD; Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR, LRCP; Sirhan Alvi, MBChB, MRCS(Ed), MRCS(Glasg)


May 12, 2016

Physical Examination and Workup

On physical examination, the patient's vital signs are noted to be normal, with a heart rate of 82 beats/min and a blood pressure of 125/67 mm Hg. Her breathing rate is 10 breaths/min, and she has a normal temperature of 98.2°F. She is a well-appearing woman in no apparent distress. Her lungs are clear, and the cardiac examination reveals a regular rate, without murmurs. The patient's breast examination shows symmetric breasts with no palpable lumps, skin changes, or nipple discharge. No palpable lymphadenopathy is observed. The findings on the rest of the physical examination are also unremarkable.

No laboratory investigations are performed as part of the baseline examination and screening mammography at the clinic; however, prior to her mammography, the patient underwent laboratory testing as part of her workup for the renal transplant, which revealed a blood urea nitrogen level of 56 mg/dL (20 mmol/L) and a baseline creatinine level of 6.2 mg/dL (548.1 µmol/L). She also has microcytic anemia, with a hemoglobin of 8.2 g/dL (82 g/L). The remainder of the metabolic panel and the complete blood count, as well as other laboratory investigations (including a coagulation profile and liver function panel), are normal.

The mammogram is obtained (see Figure).


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