Renal Biopsy of this 6 year old Child! - USMLE Forums
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Old 04-09-2011
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Kidney Renal Biopsy of this 6 year old Child!

A 6-year-old boy is brought to the pediatrician by his mother who noticed swelling around his eyes. The boy has prominent periorbital edema as well as pretibial edema. He is hypertensive. A 24-hour urine collection reveals 4.2 grams of protein. Which of the following is the most likely microscopic renal lesion?

A) Basement membrane immune complex deposition
B) Basement membrane thickening
C) Foot process effacement
D) Mesangial proliferation
E) Subepithelial immune complex deposition
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Old 04-09-2011
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Default doubt...

I think that the most common would be a minimal change disease.
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Old 04-09-2011
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Quote:
Originally Posted by JoseOrtega View Post
I think that the most common would be a minimal change disease.
I was thinking the same, but do they have hypertension in MCD
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Old 04-09-2011
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proteinuria is > 3.5, so it's minimal change disease: so I'll go for C: foot process effacement
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Old 04-09-2011
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Quote:
Originally Posted by 13monument View Post
I was thinking the same, but do they have hypertension in MCD
yes : 9-14% do have hypertension
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Old 04-09-2011
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I agree, C

Some key things about Nephrotic Syndrome in general:

In Nephrotic Syndrome, you lose Low molecular weight proteins including:
  • Transferrin --> can lead to iron deficiency anemia
  • Antithrombin III --> Can lead to clot formation
  • Complement --> Lose ability to fight capsulated bacterial (such as Pneumococci)

Also, remember to Rx with Prednisone! --> Patients respond very well
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Old 04-09-2011
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Correct Answer Correct Answer is C

You guys nailed the correct answer. Excellent.
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