Nephro!

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Nephro!

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sprint123
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04/30/07 - 12:06 PM

A 30-year-old man is seen for evaluation of nephrotic syndrome. He is not diabetic or hypertensive. He is a former user of injectable drugs ( "skin popper"). He denies arthralgia, rash, or hematuria. His blood pressure is 100/60 mm Hg. On examination, the patient has anasarca, and a large, palpable liver. Multiple old skin ulcers are noted on both lower extremities.Laboratory analysis shows:
Creatinine 1.6 mg/dL
Potassium 3.7 mEq/L
Urea nitrogen 20 mg/dL
A 24-hour urine contains 12 grams of protein with no casts. A renal ultrasound reveals echogenic kidneys, each measuring about 13 cm. An HIV test is negative. Which of the following is the most likely diagnosis?

A. AIDS nephropathy

B. Amyloid nephropathy

C. Heroin nephropathy

D. Minimal change disease

E. Poststreptococcal glomerulonephritis

star1
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04/30/07 - 12:17 PM

C. Heroin nephropathy

doc_clotaire
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04/30/07 - 12:37 PM

Yeap , This is Focal Segmental Glomerulonephritis secondary to heroin IV drug abuse nod

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sprint123
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04/30/07 - 12:44 PM

Wanna try again?!!I too chose this wrong answer smiling face

Justice
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04/30/07 - 12:57 PM

Yea, I am trying...
This is A. AIDS nephropathy

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doc_clotaire
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04/30/07 - 02:54 PM

Wao , that s UNBELIEVABLE , I totally screwed that up mad

, it just dawn on me now that s is AMYLOID NEPHOPATY . Actually Heroin Nephropaty is just a distractor . The history of skin popper and skin ulcer is a give away .

ANSWER should be B nod

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jehanzebali
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04/30/07 - 04:00 PM

hepatomegaly, enlarged kidneys smiling face

neprotic sx confirmed.. gotta b amyloid

Adam
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04/30/07 - 04:39 PM

at first, I thought it's Heroin nephropathy sad

, but i was shocked that it's wrong..

Ya, It's Amyloid nephropathy

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sprint123
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05/01/07 - 04:35 PM

Yes ...It is amyloid nephropathy.I have few questions..Please clarify me!

*Amyloid nephropathy usually present with a nephritic syndrome--Here there is no RBC'S in urine ,nO HYPETENSION,Large proteinuria--Doesn't it claasify under nephrotic which makes heroin nephropathy as an answer??

*What is the normal size of the kidney in USG????

Adam
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05/01/07 - 05:05 PM

#10

Amyloid nephropathy usually present with a nephritic syndrome--Here there is no RBC'S in urine ,nO HYPETENSION,Large proteinuria--Doesn't it claasify under nephrotic which makes heroin nephropathy as an answer??

Amyloid nephropathy usually present with nephrotic syndrome, not nephritic.

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vradojc1
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05/01/07 - 07:08 PM

#11

Normal kidney is 10-13 cm on echo.

jehanzebali
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05/05/07 - 12:41 PM

#12

Amyloid presents with Nephrotic and not nephritic syndrome.
three system diseases famous for their association with nephrotic syndrome.
DM
Amyloid
Multiple Myeloma (pneunomic DAM)

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