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  #1  
Old 07-21-2011
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Urine Sample Edema and 8 Gram Protein in Urine!

A 45 year old man comes with swollen ankles.
Physical examn shows pitting edema, periorbital swelling, urine dipstick test negative for blood, glucose but strongly positive for protein. 24 hour urine protein is 8g. What's ur diagnosis?

A. Berger's disease
B. Focal sclerosing glomerulosclerosis
C. Membranous glomerulonephritis.
D. Minimal change disease.
E. Diabetic Nephropathy.
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Old 07-21-2011
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I think C
A. Berger's disease - nephritic syndrome
B. Focal sclerosing glomerulosclerosis-Afr American, Sickle cell, AIDS may be ,but I'm not sure
D. Minimal change disease most common baby
E. Diabetic Nephropathy- glucose Normal
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  #3  
Old 07-21-2011
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Default Ans.

B.Focal Sclerosing glomerulosclerosis.
Membranous glomerulonephritis used to be number one cause of nephrotic syndrome in adults (the case vignette presents a nephrotic syndrome patient).
Number one cause nowadays is Focal sclerosing glomerulosclerosis.
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  #4  
Old 07-21-2011
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i'll go with c too
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Old 07-21-2011
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i think C becose man comes with swollen ankles,this may be rheumatoid arthritis
Rheumatoid arthritis,systemic lupus erythematosus, Graves' disease and other autoimmune disorders risk factor for membranous nephropathy!
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Old 07-21-2011
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The answer is C


Minimal change disease Commonest cause in children (75%); steroid- or cyclophosphamide-sensitive (80% of cases); nonprogressive; normal renal function; scant hematuria.

Focal and segmental glomerulosclerosis Early-onset hypertension; microscopic hematuria; progressive renal failure (75% of cases).

Membranoproliferative glomerulonephritis Peak incidence second and third decades; mixed nephrotic-nephritic features; slowly progressive in most, rapid in some; hypocomplementemia
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Old 07-21-2011
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c) most probable
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Yes, I will go with C too.
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Old 07-21-2011
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Correct Answer Correct Answer is B.

B. Focal sclerosing glomerulosclerosis.

The patient has nephrotic syndrome.
  • Focal sclerosing glomerosclerosis in recent years has become most common cause of nephrotic syndrome in adults.
  • Membranous proliferative glomerulonephritis was earlier the mc, but does have similar presentation.
  • Minimal change disease occurs in children.
  • Diabetic nephropathy, urine dipstick for glucose wud have been positive.
  • Berger: mesangial IgA deposition with symptoms of hematuria and proteinuria usually.
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