35 year-old man with a history of chronic lower back pain has been using NSAIDs daily for several months. He presents with swelling in his leg, foamy urine, and elevated blood pressure. Laboratory test reveals hypoalbuminemia and significant proteinuria.
سؤال مجاني 1 من 10 اليوم · اشترك وكمّل بدون حد
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الإجابة والشرح
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الإجابة: C. Membranous nephropathy
Oedema, foamy urine, heavy proteinuria and hypoalbuminaemia = nephrotic syndrome. In this patient it follows months of daily NSAIDs. Of the options, membranous nephropathy is the nephrotic lesion listed with NSAIDs as a secondary cause (with penicillamine and gold).
- NSAIDs also cause minimal change disease, but MCD is not offered.
- FSGS secondary causes are HIV, heroin, interferon and sickle cell.
- ATN and AIN cause AKI, not nephrotic-range proteinuria.
ليش كل خيار صح أو غلط
-
A
ليش غلط
FSGS has secondary causes such as HIV, heroin, interferon and sickle cell (and is seen in African American adults), not NSAIDs.
✓ Glomerular Diseases [Notes].pdf · p. 1 -
B
ليش غلط
ATN is tubular injury causing AKI (falling GFR, rising creatinine and BUN, low urine output), not a nephrotic syndrome with heavy proteinuria and oedema.
✓ Acute Kidney Injury [Notes].pdf · p. 5 -
C
ليش صح
Membranous nephropathy has secondary causes including drugs (penicillamine, gold, NSAIDs), infections (HBV, HCV, syphilis) and SLE, and presents with nonselective nephrotic proteinuria.
✓ Glomerular Diseases [Notes].pdf · p. 1 -
D
ليش غلط
AIN (also drug-related, including NSAIDs) shows fever, rash, leucocyturia, eosinophiluria and white cell casts with minimal proteinuria, not heavy nephrotic proteinuria.
✓ AKI Davidson.pdf · p. 2
- المصدر
- Glomerular Diseases [Notes].pdf · p. 1
Nephrotic syndrome.pdf · p. 8 - المحاضرة
- Glomerular Diseases · Nephrology · Module C
- ظهر في
- MED43 ♀ Compre · MED42 ♀ EOM C · MED41 ♂ EOM C