Nephrology

Question 1

what is the classic presentation of nephrotic syndrome in a child?

Answer 1

• periorbital / pitting oedema
• low BP
• frothy urine- proteinuria

Question 2

what are the most common nephrotic syndromes and outline their main difference

Answer 2

• minimal change disease 80-90%
  
  • steroid sensitive
• focal segmental glomerulosclerosis 10%
  
  • steroid resistant

Question 3

what is the treatment of nephrotic syndrome?

Answer 3

prednisolone for 8 weeks

Question 4

what are some causes of macroscopic / microscopic haematuria?

Answer 4

• UTI
• trauma
• stones
• glomerulonephritis
  
  • IgA
  • post-infectious

Question 5

signs and symptoms of nephritic syndrome?

Answer 5

• haematuria & proteinura
• low GFR –> oliguria, fluid overload, HT, worsening renal failure

Question 6

pathophysiology of HSP?

Answer 6

IgA mediated vasculitis, often following viral URTI

Question 7

what is the typical age of onset of Henoch Schonlein Purpura (HSP)?

Answer 7

peak 4-6years

Question 8

clinical diagnosis of HSP? (4)

Answer 8

• purpura
  
  • predominantly on thigh and buttocks
• athralgia /arthritis
• abdominal pain
• GN

Question 9

when does HSP occur?

Answer 9

1-3 days post trigger ie infection, drug etc

Question 10

Mx of HSP

Answer 10

• supportive
  
  • fluids & NSAIDs
  • steroids if severe

Question 11

prognosis of HSP & complication?

Answer 11

prognosis: self-limiting
complication: intusussception

Question 12

natural history of aquiring Haemolytic Uraemic Syndrome?

Answer 12

bloody diarrhoea after contracting enterohaemorrhagic E.Coli

Question 13

clinical features of HUS?

Answer 13

• microangiopathic haemolytic anaemia
• thrombocytopenia
• AKI

Question 14

Management of HUS?

Answer 14

Monitor - acidosis, electrolytes, HT, fluid balance

Maintain- good hydration

Minimise - no antibiotics