Practice exam SAQ 22 J Taylor. Question 22 A 22 month old previously well boy presents to your tertiary Emergency Department. He has a one week history.

Slides:

Advertisements

Similar presentations

Hematuria Katie Townes MD, PGY2. Case 8 year old male with episodic hematuria, initially thought to be due to trauma, but persisted for weeks and recurred.

Advertisements

Orange Urine on Halloween

Glomerulonephritis in children

Nephrotic Syndrome in Children Laura Cornish GPST2 Airedale VTS

Nephrotic/nephritic syndrome

Assessing Renal Patients SHARONDEEP GILL. Overview Chronic Kidney Disease History Examination Fistula Cases Clinical Topics Summary.

ROLLO CLIFFORD.  Diagnosis  Treatment  Assessment:  History  Examination  Referral.

U # month history of being unwell Vasculitic lesions on lower limbs ANCA positive Likely Wegener’s vs MPA.

Urinary tract infections … I can’t wait…. Symptoms of UTI: Dysuria, frequency, urgency, suprapubic tenderness, haematuria, polyuria.

Kidney biopsies at Southampton General Hospital, UK Dr Pankaj Deshpande.

Proteinuria 24 th June 2011 Rachel Lennon. The Spectrum of Glomerular Disease Minimal change Proteinuria FSGS IgA nephropathy Membranous Diabetic nephropathy.

Nephrotic and Nephritic Syndrome

Glomerular Diseases Dr. Atapour Differential diagnosis and evaluation of glomerular disease.

A retrospective cohort study of Childhood post-streptococcal glomerulonephritis as a risk factor for chronic renal disease in later life Andrew V White,

Case Presentation Dr Mohan Shenoy Consultant Paediatric Nephrologist Royal Manchester Children’s Hospital.

Case D 1 Age 37 M HIV for 17 years 1 week history of diarrhoea and fever Abrupt onset of oedema and oliguria Homosexual Teenage drug abuse.

A Painful, Purpuric Rash

Nephrosis and Nephritis

Nephrotic nephritic syndrome By Dr Rasol M Hasan.

This lecture was conducted during the Nephrology Unit Grand Ground by Medical Student rotated under Nephrology Division under the supervision of Prof.

Glomerular Diseases Dr Rebecca Martin F2. Learning objectives 1.Appreciate the fact that glomerular diseases fall onto a wide spectrum 2.Be able to define.

This lecture was conducted during the Nephrology Unit Grand Ground by Medical Student under Nephrology Division under the supervision and administration.

Diabetes Exam Question Kieran Kitchener. Question 1 Amritpal, a 10 year old boy, has developed a flu-like illness over the last few months according to.

Hematuria. CONTINUITY CLINIC Objectives Plan the appropriate management of a child with microscopic hematuria Plan the appropriate management of a child.

Zehra Eren M.D. Nephrology Department. The Kidney in:  Congestive heart failure  Liver disease  Diabetes Mellitus  Systemic Vasculitis  İnfections.

2007. Risk factors for UTI  Poor urine flow  Previous proved or suspected UTI  Recurrent fever of unknown origin  Antenatally diagnosed renal abnormality.

Red Urine – a mystery Shaila Sukthankar.

Proteinuria DR Badi AlEnazi Consultant pediatric endocrinology and diabetologest.

Kidney Disorders and Diseases 1.Hypertension: High Blood Pressure Narrowed arteries in the kidneys increases production of renin (protein) that can damage.

Ricki Otten MT(ASCP)SC

Digestive System. A pt present to the ER c/o pain in RUQ that radiates to his right shoulder. He has had a weight loss of 15 pounds over the last month.

THE OFFICE EVALUATION OF HEMATURIA AND PROTEINURIA: CASE PRESENTATIONS Debbie Gipson, M.D., M.S. University of North Carolina-Chapel Hill.

Acute Glomerular Nephritis

Urinary System Tutorial Glomerulonephritis

Glomerulonephritis Dr. Abdelaty Shawky Dr. Gehan mohamed.

2006 Renal Week Lecture 3 Hematuria and Glomerulonephritis Debbie Gipson UNC Kidney Cener website: password:

U and U # U y.o. male ? Wegener’s.

Heamaturia Dr.Badi AlEnazi Consultant pediatric endocrinologest and diabetologest.

U # y.o. male with increased proteinuria, arthralgia and lower limb petechial rash. Hypertension ? Renal vasculitis ? Henoch-Schönlein.

Diagnostic Approach to Vasculitis

Rule Out UTI. Shaikh N et al. Prevalence of urinary tract infections in childhood. A meta- analysis. Ped Infect Dis J 2008.

NYU Medical Grand Rounds Clinical Vignette Matko Kalac, MD PGY-2 9/18/2012 U NITED S TATES D EPARTMENT OF V ETERANS A FFAIRS.

“You’re the doctor” – a urinary system review Prof John Simpson.

Glomerulonephritis Brian S. Pavey, DO, MS. Presentation Sudden onset – Hematuria – Hypertension – Edema – Acute kidney injury.

Case Presentation Name: xxxxx (Do not give complete name.) Chart # Bed # Age: Gender: Date of Admission: Do not read these two items in the presentation.

Paediatrics 4 Microteaching: Haematuria in children Zara Gall Victoria Hopkinson Shahid Islam (Previous presentation by Satish Maddenini and Lynsey McHugh)

Microscopic Haematuria. Transient Causes Transient –UTI –Exercise Spurious –Menstrual contamination –Sexual intercourse.

POST INFECTIOUS GLOMERULONEPHRITIS (PIGN) Dr. Nariman Fahmi Ahmed Azat.

Dr. Aya M. Serry Glomerulonephritis Glomerul/o/nephr/it is glomeruli kidney inflammation Alternative names: acute/chronic nephritis, glomerular.

This lecture was conducted during the Nephrology Unit Grand Ground by Medical Student under Nephrology Division under the supervision and administration.

Hazem.K.Al-Khafaji FICMS Department of internal medicine College of medicine Al-Qadissyia University.

GLOMERULONEPHRITIS DR. HANY ELSAYED LECTURER OF PEDIATRICS.

Hematuria Resident Lecture

Glomerular diseases typical case reports morphology Doc. MUDr. Zdeňka Vernerová, CSc., MUDr. Martin Havrda.

U Clinical History A 53 year old man who had very little or no medical care in the past, presents to ER with the only complaint of insomnia.

Glomerulonephritis By Dr. Abdelaty Shawky Associate professor of pathology.

HEMATURIA DAVID SPELLBERG M.D.,FACS NAPLES UROLOGY ASSOCIATES.

KDIGO guidelines glomerulonephritis Dr.. Overview Rationale for requirement of guidelines KDIGO: GN Guidelines  Scope Clinical Nephrology Conferences.

An approach to a child with oedema

Nephritic and nephrotic syndromes

Symptom in the context of abnormal renal variables

An approach to a child with oedema

Henoch–Schönlein Purpura (HEN-awk SHURN-line PUR-pu-ruh)

L. Aya M. Serry Glomerulonephritis 2017

Acute poststreptococcal GN

OSCE Mini exam clinical stations in surgery

Nephrology cases Dr . Hayam Hebah.

World Kidney Day 2016: Kidney Disease & Children

Princess Margaret Hospital Dr. Winsome Lo

Presentation transcript:

Practice exam SAQ 22 J Taylor

Question 22 A 22 month old previously well boy presents to your tertiary Emergency Department. He has a one week history of periorbital oedema and bilateral leg swelling. He has had no fever and no recent illnesses. On examination he has normal vital signs.

Describe the urine dipstick giving three (3) positive and three (3) relevant negative findings.

3 positive findings Haematuria (marked) Proteinuria (marked) Slightly acidic urine pH6.5 Other positives?

3 negative findings No evidence of infection (no nitrites, no leuks) No evidence jaundice (ie hepato-renal syndrome) ie no Bili/Urobili No evidence of diabetes/DKA- no glucose or ketones Not overly concentrated urine ?

Most likely Diagnosis Glomerulonephritis (Nephritis vs nephrotic)

3 underlying causes for GN IgA GN Post strep GN (>2yo) Vasculitis – eg HSP (>6yo), PAN Connective tissue disorder – SLE Genetic - young Urine infection Membranoproliferative GN Drugs/toxins

Four complications Fluid overload – oedema /CCF Hypertension – seizures/encephalopathy Renal failure Lethargy/fatigue Hyperkalaemia/hyponatraemia

Remember Read the stem carefully Keep answers relevant to age group Answer ALL sections Have broad differential diagnoses Try to value add (within the time allowed/points allocated)