Keywords

  • 5 y/o boy
  • progressive swelling of lower limbs & puffy face (2 weeks)
  • swelling of abdomen (1 week)
  • Frothy urine
  • easily tired, breathless on exertion
  • examined by doctor: generalised oedema, hydrothorax, ascites, gross pitting pedal oedema
  • CVS normal
  • Hb low
  • Urea & creatinine normal
  • Serum albumin low
  • Alkaline transaminase & alkaline phosphatase normal
  • Urinalysis: Protein present, no blood
  • 24 hour urinary protein: 5gm (high)

Hypothesis

Renal disease/failure

Nephrotic syndrome

Acute nephritic syndrome

Asymptomatic hematuria/proteinuria

Chronic renal failure

Rapidly progressive glomerulonephritis

Learning issues

1)Syndromes

  • Nephrotic syndrome
  • Acute nephritic syndrome
  • Asymptomatic hematuria/proteinuria
  • Chronic renal failure
  • Rapidly progressive glomerulonephritis

– Causes (primary & secondary)

– Pathogenesis

– Complications

– Prognosis

2) Acute glomerulonephritis

– How is it different from nephritic syndrome

3) Explanation for clinical features

– generalized oedema

– gross pitting pedal oedema

– hydrothorax

– ascites

– abdominal swelling

– frothy urine (protein)

– tired, breathless on exertion

4) Investigations

– Staining

– Biopsy

– Low hb (anemia)

– Urea & Creatinine normal

– Hypoalbuminemia

– Normal alkaline transaminase & alkaline phosphatase (liver)

– Protein in urine, no blood in urine

– Cholesterol

5) Treatment

– Outline

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