What this deck covers
Nephrotic Syndrome in Children – 18 Teaching Cases in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.
Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.
The 18 cases, in order
- Puffy eyes, protein 4+, no blood
- First episode, what dose and how
- High pressure, casts, low C3
- Three dry mornings on day twelve
- Relapses every time the dose drops
- Six weeks of steroid, still 3+
- Belly pain and cloudy ascites
- Why he keeps catching infections
- Loin pain and red urine in relapse
- Swollen but cold and shut down
- Breathless as the infusion finished
- Immunisation while on steroids
- Swollen from birth, huge placenta
- Rash, ulcers, sore wrists at twelve
- Why is the cholesterol so high
- Cataracts and a falling centile
- Discharge plan for the family
- What do we tell the parents
Diagnoses and management options tested
Across the 18 cases you are asked to choose between options such as: Minimal change disease, Intravenous methylprednisolone pulses for three days, Repeat the urine protein measurement in two weeks, Partial remission, so the dose should be increased, Steroid resistant nephrotic syndrome, Renal biopsy and start a calcineurin inhibitor, Staphylococcus aureus, T lymphocyte depletion from the heavy protein losses, Renal vein thrombosis on the left side, Intravenous furosemide alone, given twice daily, An anaphylactic reaction to the infused albumin, COL4A5, Minimal change disease of adolescent onset, Dietary excess that was present before the illness.
Clinical pearls from this deck
- Between one and ten years with a clean nephrotic picture, treat first and biopsy only if the child breaks the rules.
- Dose steroids in nephrotic syndrome by surface area, not by weight, and finish the alternate day phase – stopping early buys a relapse.
- Nephrotic plus hypertension, haematuria, low C3 or a raised creatinine is not minimal change disease – biopsy before you treat.
- Judge remission on three consecutive EARLY MORNING samples; daytime proteinuria can be postural and means nothing.
- Dependence is about WHEN the relapse happens; frequency is about HOW OFTEN. They are different definitions and both trigger a steroid sparing agent.
- Steroid resistance is the one nephrotic pattern that actually threatens the kidney, and it is the one where genetics changes management.
Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.
More from this system: all nephrology case decks · pediatric reference values.
