Idiopathic
Forum Guru
Topics: 19
Posts: 641
|
A 4-year old child presents to the ER with a case of Streptococcus peritonitis. What other condition is most likely present in this child?
a. decreased CD4 count.
b. proteinuria >3g/day.
c. duodenal ulcer perforation.
d. lobar pneumonia from Streptococcus pneumoniae.
e. ruptured appendix.
f. alpha-1 antotrypsin deficiency.
|
| asmi
Forum Hero
Topics: 1043
Posts: 4,609
|
is it A
|
|
|
nope.
|
| Idiopathic
Forum Guru
Topics: 19
Posts: 641
|
Crap...I mean nope. :oops:
|
|
|
is it D
|
| asmi
Forum Hero
Topics: 1043
Posts: 4,609
|
is it D
|
| Idiopathic
Forum Guru
Topics: 19
Posts: 641
|
The answer is B. Spontaneous peritonitis in a child is strongly associated with nephrotic syndrome, which consists of: proteinuria >3g/day, hyperlipidemia, hypoalbuminemia, edema.
|
| asmi
Forum Hero
Topics: 1043
Posts: 4,609
|
but >95% of poststrep GN is curable right?
Thats why i didn't consider that choice.
|
| alice8
Forum Guru
Topics: 37
Posts: 643
|
i agree so b. proteinuria >3g/day.
___________________
Dream on 'til your dream comes true.
|
| Idiopathic
Forum Guru
Topics: 19
Posts: 641
|
It is peritonitis secondary to renal disease, not the other way around. nephrotic syndrome in children (i.e. lipoid nephrosis, minimal change disease) predisposes to strep peritonitis.
|
| asmi
Forum Hero
Topics: 1043
Posts: 4,609
|
got it, i was thinking otherway round :?
thanks
|
| asmi
Forum Hero
Topics: 1043
Posts: 4,609
|
Is peritonitis common complication in minimal change or lipoid nephrosis ?
:roll: I read that prognosis is excellent.
The commonest age given 6 to 8 yrs for MCD.
|
| bluestar
Forum Guru
Topics: 236
Posts: 724
|
why is it that children with minimal change nephritis are prone to infection? they only lose albumin and not gamma-globulin in the urine, so shouldn't compromise their immunity that much. also, why is there hyperlipidemia in this disease?
___________________
I leave no trace of wings in the air, but I am glad I have had my flight
|
| mani
Forum Guru
Topics: 104
Posts: 1,403
|
NS pts are predisposed to infections, many pathogenetic mechanisms suggested but none 100%
___________________
Sincerity and hard work are the keys to success!
|
| Gul
Forum Elite
Topics: 9
Posts: 259
|
Thats right, pts of nephrotic syndrome with ascites are in particular at risk to spontaneous peitonitis.
|
| Idiopathic
Forum Guru
Topics: 19
Posts: 641
|
"bluestar" wrote:
why is it that children with minimal change nephritis are prone to infection? they only lose albumin and not gamma-globulin in the urine, so shouldn't compromise their immunity that much. also, why is there hyperlipidemia in this disease?
I think it is due to the stasis of fluid in the abdomen (ascites) as cirrhotic patients are also prone to developing spontaneous peritonitis (although with e. coli).
|
| Gul
Forum Elite
Topics: 9
Posts: 259
|
Yes, u're right..
|
| bluestar
Forum Guru
Topics: 236
Posts: 724
|
"Idiopathic" wrote:
I think it is due to the stasis of fluid in the abdomen (ascites) as cirrhotic patients are also prone to developing spontaneous peritonitis (although with e. coli).
Then can we get a generalized conclusion that patients with edema are prone to infection because of stasis of fluid? like the generalized edema in CHF?
My other question is why there is hyperlipidemia in this disease?
___________________
I leave no trace of wings in the air, but I am glad I have had my flight
|
| Idiopathic
Forum Guru
Topics: 19
Posts: 641
|
Hypoalbuminemia leads to a lack of carrier for the transport of fatty acids and this is compensated by an increase in fractions linked to lipoproteins. Also synthesis of lipids and albumin takes place in the liver. Hypoalbuminemia leads to an increased stimulus for synthesis of proteins and of LDL, and VLDL cholesterol by the liver.
|
| bluestar
Forum Guru
Topics: 236
Posts: 724
|
I see. thank you very much!
___________________
I leave no trace of wings in the air, but I am glad I have had my flight
|
| bright_nnn
Forum Senior
Topics: 17
Posts: 97
|
I dont believe that ascites has anything to do woth more Infection.
It is the steroid therapy tat is the real culprit given as Rx of Nephrotic syndrome.
|
| bluestar
Forum Guru
Topics: 236
Posts: 724
|
oh? and plz justify your point.
___________________
I leave no trace of wings in the air, but I am glad I have had my flight
|
| bright_nnn
Forum Senior
Topics: 17
Posts: 97
|
:oops: I am Sorry
It is Infections directly caused by NS.
(ref.:Goljan)
Reason: Hypogammaglobulinemia
|
| bluestar
Forum Guru
Topics: 236
Posts: 724
|
does hypoalbuminemia has direct connection with infection? or it's still Idiopathic's explanation: stasis of fluid in abdomen causes infection?
___________________
I leave no trace of wings in the air, but I am glad I have had my flight
|
| mdwannabe
Forum Guru
Topics: 37
Posts: 1,133
|
Wowo so many views!!!! That is wonderful!!! Please keep on asking... :-)
This q gives a good underscore of peds vs. adult :-)
I am so glad..this has come out... :-) trully.. It is so important!!
___________________
"Life not lived for others, is not worth living" Uncle Einstein
"A life is not important, except in the impact it has on other lives" -Jackie Robinson
|
|
| |
| | | | | | | | | | | | | | | | | | | | | | | | | |
