new_n_lost
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A 25-year-old man developed bilateral loin pain and frank hematuria. His symptoms had started 24 hours after developing a sore throat. His blood pressure was 138/88 mmHg. Urinalysis was positive for blood (4+) and protein (2+)
What is the most likely diagnosis?
1) IgA nephropathy
2) Microscopic polyangiitis
3) Nephrolithiasis
4) Post-streptococcal glomerulonephritis
5) Septicemia
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| mytime
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4. PSGN.
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| epica
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Sure, typical case
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| new_n_lost
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| mytime
Kick my butt!
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Ok since that's more common in children ,i'll go with IgA...... but just this much info can go either way . Also since IgA is MCC in US i choose that........ not PS.
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| epica
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Wow, missed imp. Q, should pay attention.
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| epica
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Ok, it should some small clue to get IgA ( complement or something else) Please review the Q, maybe u missed something
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| new_n_lost
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Guys Honestly Tell me if the Pt has Sore Thorat with a history of ONE day will he/she present as a Post Streptococcal GN
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| new_n_lost
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Remember i was telling u that i messed up easy ones n i hate myself for that well this is one of them.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| epica
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Should be IgA Nephropathy after 24h? Should be some additional inform ( celiac dis. for example) or given biopsy
For IgA ----- recurrent hematurria
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| new_n_lost
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Epica U r Missing Question 4
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| mytime
Kick my butt!
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Hey it's IgA........... that i know for sure but Didn't see 24hrs....hence picked the wrong choice first even when i knew..it's the other.....coz another thing pSGN will have low C3 levels and that they'll have to write.
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| epica
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yes my boss, 
Edited by epica on 04/05/07 - 06:31 PM
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| new_n_lost
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The acute onset of the disease is suggestive of IgA nephropathy which characteristically occurs in young males in their 20s and 30s. Hematuria occurs within 12-24 hours of pharyngitis, accompanied also by loin pain, muscle pain and fever. Prognosis is usually good especially in children. In adults, between 25-50% may develop end-stage renal failure. No specific treatment available.
Classically, patient wud have a streptococcal infection 1-3 weeks before the onset of acute nephritic syndrome (post-strep GN). There is a long prodromal systemic illness lasting months or years in microscopic polyangitis which differs from Wegener's granulomatosis in its absence of respiratory tract granulomatous inflammation.
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FORUM RULES-- Those who believe in telekinesis, raise my hand. I get enough exercise just by pushing my luck --P4U World.." The pure and simple truth is rarely pure and never simple."
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| mytime
Kick my butt!
Topics: 39
Posts: 3,174
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Hematuria occurs within 12-24 hours of pharyngitis, accompanied also by loin pain, muscle pain and fever......
Didn't know this was a must.
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