Steroid-Resistant Nephrotic Syndrome – Board-Style Questions

What this deck covers

Steroid-Resistant Nephrotic Syndrome 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Counting the weeks
2. The child who is not resistant
3. Dry inside, wet outside
4. When albumin earns its place
5. Who is tested first
6. What the result changes
7. The fever that matters
8. The clot nobody expects
9. Halfway there
10. The creatinine that crept up
11. Two years on the drug
12. Where rituximab belongs
13. Nephrotic at six weeks
14. The gland that is also leaking
15. Growing up on treatment
16. A letter from the nursery
17. Two teenagers, one list
18. What the family are told

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: Steroid resistance, which changes the whole plan of care, Start a calcineurin inhibitor while adherence is sorted out, Intravascular depletion despite her obvious oedema, Whenever the serum albumin falls below a set threshold, The 8-year-old whose biopsy shows minimal change disease, Nothing, as the drug should be given a full six months, Spontaneous bacterial peritonitis in the ascitic fluid, Cellulitis of the leg, which is common in oedema, A failure of this treatment, which should therefore be changed, Progression of the underlying glomerular disease itself, A repeat biopsy to look for chronic drug-induced damage, It is too dangerous to use in any child with kidney disease, A trial of high-dose corticosteroids for a full four weeks, Because congenital hypothyroidism is common in these infants.

Clinical pearls from this deck

• Four weeks without remission is a diagnosis, not a delay.
• A medicine never swallowed has not failed.
• Swollen outside can mean empty inside.
• Albumin is for the child’s circulation, not for the laboratory report.
• Test the baby’s genes before you reach for the drugs.
• A gene result can be a reason to stop treating, not to treat harder.

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.