Glomerulonephritis

Question 1

You are seeing Timothy, a 7 year old boy, for a 6 monthly follow-up for microscopic haematuria since an episode of Henoch-Schonlein purpura 18 months ago. You are checking his urine for ongoing microscopic haematuria.

What other item should you check as part of his follow-up?

Question 1Select one:

a.
Blood pressure

b.
Platelet function

c.
Coagulation test

d.
Kidney palpation

Answer 1

Blood pressure

Question 2

Question text
Leon is 4 years old and has been diagnosed with acute nephritic syndrome, due to Post Streptococcal Glomerulonephritis (PSGN). While he is being evaluated he has a generalised tonic-clonic seizure lasting 10 minutes. What is the most likely cause of the seizure?

Question 2Select one:

a.
Hypernatraemia

b.
Hypoglycemia

c.
Hypocalcaemia

d.
Hypertension

Answer 2

Hypertension

Question 3

You are examining a 4 year old girl Leena who has presented with oedema and proteinuria. You are considering a diagnosis of nephrotic syndrome. What other characteristic of nephrotic syndrome would help confirm this diagnosis?

Question 3Select one:

a.
Microscopic haematuria

b.
Very low serum albumin

c.
Hypertensive seizures

d.
Intra-renal kidney failure

Answer 3

Very low serum albumin

Question 4

A 7-year-old boy presents with puffiness of the face and reduced urine volumes. His urine is brown smoky in appearance. He is generally unwell but was well until 5 days ago. Examination reveals a child with some facial swelling, minimal oedema of the legs and a blood pressure of 160/110. Dipstick urine contains protein 2+, blood 4+. WHICH ONE of the following is the MOST LIKELY diagnosis?

Question 4Select one:

a.
Nephritic syndrome

b.
Adenovirus cystitis

c.
Ureteric obstruction

d.
Nephrotic syndrome

Answer 4

Nephritic

Question 5

A 3-year-old girl Hannah presents with a three-week history of increasing puffiness of the face and lower extremities. She has been vaguely unwell during this time but was previously healthy. Examination reveals moderate generalised oedema of her legs and pitting oedema of the sacrum. Blood pressure is 85/50. Dip stick urine shows protein 4+, no white blood cells, and no haematuria. WHICH ONE of the following is the MOST LIKELY diagnosis (GN=glomerulonephritis)

Question 5Select one:

a.
IgA nephropathy

b.
Post-streptococcal GN

c.
Minimal change GN

d.
Membranous GN

Answer 5

Minimal change GN

90% nephritic due to MC GN

Question 6

Heather, the mother of Tommy, aged 8 years, is concerned because he complained to her of having red urine, which she checked. When you take a history from her, you find that at dinner last night, they had a jellied beetroot dish, which she thought the kids might like better than beetroot in the salad. You wonder if the beetroot ingestion is connected to the red urine.

WHICH ONE of the following is the MOST LIKELY underlying cause for the passage of red urine following the ingestion of beetroot

Question 6Select one:

a.
No underlying abnormality

b.
BTRT-kinase deficiency

c.
Focal glomerulosclerosis

d.
a-1 antitrypsin deficiency

Answer 6

No underlying abnormality

Question 7

Matthias, aged 7 has been admitted for investigation of macroscopic haematuria.

WHICH ONE of the following is the MOST SPECIFIC diagnostic indicator that the blood comes from the glomeruli (as in glomerulonephritis) and is associated with acute nephritic syndrome?

Question 7Select one:

a.
Red cell casts in urine

b.
Raised serum creatinine

c.
Microscopic haematuria

d.
Symptomatic proteinuria

Answer 7

Red cell casts in urine

Question 8

Samantha, who is 11 years old, has developed gross generalised oedema, ascites and proteinuria. You are concerned about the possibility of acute nephrotic syndrome. The recognition of nephrotic syndrome in children is based on WHICH ONE of the following criteria?

Question 8Select one:

a.
Raised creatinine and oliguria

b.
Heavy proteinuria and oedema

c.
Haematuria and hypertension

d.
Low complement and peritonitis

Answer 8

Heavy proteinuria and oedema

Question 9

Samantha is 6 years old and has been admitted to hospital with acute nephrotic syndrome. She has gross oedema, asciteand heavy proteinuria with hypoalbuminaemia. Her mother asks you about the treatment of nephrotic syndrome.

WHICH ONE of the following is the cornerstone of treatment of acute nephrotic syndrome in children?

Question 9Select one:

a.
Oral prednisone

b.
Low protein diet

c.
High protein diet

d.
Antihypertensives

Answer 9

.
Oral prednisone