Nephrology and Urology – Set 4

What this deck covers

Nephrology and Urology – Set 4 in 50 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Proof that the kidney is inflamed
2. Cola urine after a sore throat
3. Pallor a week after bloody stools
4. Why the pressure climbs in nephritis
5. A dry toddler with a clear chest
6. White cells beside the red casts
7. Haematuria, uncle on dialysis
8. Small kidney, bruit, low potassium
9. The eye in familial kidney disease
10. Breathless after a day without urine
11. One tablet for every lupus patient
12. Red urine with every cold
13. Hunting the germ behind the illness
14. A drug to hold back in oliguria
15. Pale and puffy once more
16. Protein creeping up in IgA disease
17. Blood tests that settle the cause
18. Double vision and swollen discs
19. A family tree of haematuria
20. A low count and a few skin spots
21. A new diagnosis, protein still normal
22. Lung bleeding with crescents
23. Ruling out the look-alike
24. Breathless three days after diagnosis
25. Seizure on day 5 of the illness
26. Crescents and a bare biopsy stain
27. Purpura with a clear urine
28. Lupus, a gallop and wet lungs
29. No urine, wet lungs, high potassium
30. First look at a suspect artery
31. Protein persists after six months
32. Crescents and blood in the sputum
33. How quickly to bring it down
34. Severe anaemia with kidney injury
35. Pressure still up after a day of care
36. Two things to leave out
37. Headache, vomiting and a fit
38. A low platelet count under suspicion
39. What to expect in the months ahead
40. The study that ends the uncertainty
41. Nephritis, then fever and loin pain
42. A biopsy that sets the first regimen
43. Searching for the root of a relapse
44. Proving a hereditary nephritis
45. No urine and a stubborn potassium
46. Lungs and kidneys struck together
47. A convulsion on the fourth day
48. Swollen ankles and a rising pressure
49. Dipstick three weeks after nephritis
50. What it takes to make the diagnosis

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: Red cell casts in the urine and a low serum C3, Salt and water retention expanding her circulation, Thin basement membrane nephropathy, An ACE inhibitor or angiotensin receptor blocker, PKD1, autosomal dominant, Anti-GBM (Goodpasture) disease, A febrile convulsion, Lupus myocarditis with poor contraction, Oral glucocorticoids added to her current treatment, Packed red cells, transfused slowly, Intravenous nicardipine by infusion, Magnetic resonance angiography, Bone marrow aspirate with cytogenetics, Immune complexes lodge in both capillary beds.

Clinical pearls from this deck

• Look for casts under the microscope before calling dark urine an infection.
• Count the days between the sore throat and the dark urine.
• A haemolysis that spares the Coombs test and cuts the cells is happening in the small vessels.
• In acute nephritis the pressure is high because the tank is full.
• Decide the fluid by examining the child, and decide again in a few hours.
• Read the white cells by the company they keep.

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 and urology case decks · pediatric reference values.