USMLEGladiator
2009 & still in race
Topics: 135
Posts: 509
|
form1-
this is tricky one
16. A 6-year-old girl is brought to the physician because of a 4-week history of headache, fatigue, and decreased appetite. During this period, she has had nausea and vomiting. At the age of 4 years, she was diagnosed with poststreptococcal glomerulonephritis. She is at the 15th percentile for height and the 10th percentile for weight. Examination shows no abnormalities. Her serum urea nitrogen (BUN) level is 50 mg/dL. Which of the following is most likely to limit progression of this patient's renal failure?
A
) Increased potassium and sodium bicarbonate intake
B
) Decreased sodium and daily calorie intake
C
) Low-protein diet
D
) Strict fluid restriction
E
) Dialysis
___________________
Chance favors only the prepared mind. - Louis Pasteur.
|
| hero
Forum Guru
Topics: 42
Posts: 557
|
C. Only low protein diet slowing progression of RF.
|
| USMLEGladiator
2009 & still in race
Topics: 135
Posts: 509
|
ans????????CCCCC
) Low-protein diet??????????
- Although dietary protein restriction
has been shown to be useful in adults, this recommendation is
generally not suggested for children with CKD because of the
concern of adverse effects on growth and development.
___________________
Chance favors only the prepared mind. - Louis Pasteur.
|
| USMLEGladiator
2009 & still in race
Topics: 135
Posts: 509
|
can ans be BBBBB----but low calor diet not recomended in grwoing child???????
___________________
Chance favors only the prepared mind. - Louis Pasteur.
|
| USMLEGladiator
2009 & still in race
Topics: 135
Posts: 509
|
ans A is wrong as in CKD though NAHCO3 req is increased, K should be restricted
ans B is wrong as Na and calorie ( at least )should be provided at par with daily recommended allowance
ans D and E is wrong as they are applicable only in ESRD which is a small portion of CKD and according to BUN value, the child most probably not in CKD5 or ESRD
according to modern concept though choice C is also wrong( new reco to provide 2.5 mg/kg /day), for USMLE it would be appropriate to go with this.
___________________
Chance favors only the prepared mind. - Louis Pasteur.
|
| hero
Forum Guru
Topics: 42
Posts: 557
|
protein restriction diet means that you are not consuming more than absolutely necessary, 0,8 gram per kilo for healthy person and i don't remember numbers but it seems bit less for RF pts. Average consumption of protein is times more than necessary
one small portion of fish (almost totally protein - 3 oz =112 gram - for 6 year-old girl at 15 percentile - less than 20 kilo her weight - she needs 16 gram of protein per day!!
average kid with average parents eats much more of a protein than that
Edited by hero on 07/04/08 - 11:06 AM
|
|
| |
| | | | | | |
