What this deck covers
Acute Glomerulonephritis in Children 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
- Dark urine three weeks after a sore throat
- Smoky urine six weeks after impetigo
- Where the complement goes from here
- Puffy and passing little urine
- Seizure with a pressure of 165 over 110
- Still blood on the stick at six weeks
- Red urine on day two of a sore throat
- C3 still low four months later
- Purpura today, urine clear today
- Swollen eyes three weeks into the purpura
- Creatinine trebles in six days
- Crusty nose, haemoptysis, dark urine
- Malar rash, sore wrists, dark urine
- Haematuria, hearing aids, an uncle on dialysis
- Blood in the urine that runs in the family
- One positive stick in a well child
- What penicillin can and cannot stop
- Breathless overnight with a gallop
Diagnoses and management options tested
Across the 18 cases you are asked to choose between options such as: Post-infectious glomerulonephritis, Antistreptolysin O titre, It is unhelpful once the child is clinically better, Start high dose oral prednisolone, Gradually, with an intravenous infusion, The nephritis has relapsed and needs treating again, Alport syndrome, A second streptococcal infection, Urine and blood pressure checks for six months, Continue weekly urine checks and review in a month, Repeat the creatinine in one week, Antistreptolysin O and anti-DNase B titres, Anti-double stranded DNA antibodies, Autosomal recessive.
Clinical pearls from this deck
- A low C3 with a normal C4 in a child with nephritis points to the post-infectious cause, and it should be back to normal within eight weeks.
- After impetigo ask for anti-DNase B; the antistreptolysin O titre is often flat because skin lipids neutralise streptolysin O.
- Recheck the C3 at eight weeks; if it is still low at twelve, the diagnosis was never post-infectious nephritis.
- In acute nephritis the enemy is salt and water; treat the pressure with restriction and a loop diuretic, not with steroids.
- In hypertensive encephalopathy the speed of correction can do more harm than the pressure; no more than a quarter in the first eight hours.
- Haematuria is the slowest thing to clear after post-infectious nephritis; two years is normal, provided pressure, creatinine and protein are not.
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.
