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  #1  
Old 06-04-2012
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Kidney 21 year with nephrotic syndrome ... which type ?

A 21-year-old woman is evaluated in the office for facial and lower-extremity edema of 1 week's duration. For the past 3 weeks, she has had fatigue. She has no history of diabetes mellitus, cigarette smoking, or illicit drug use.

On physical examination, blood pressure is 90/55 mm Hg. Cardiac and pulmonary examinations are normal. The abdomen is soft and without masses. There is periorbital edema and 2+ lower-extremity edema.

Laboratory Studies
Creatinine

0.7 mg/dL
Total cholesterol

325 mg/dL
Albumin

2.9 g/dL
Complement (C3 and C4)

Normal
Urinalysis

Specific gravity 1.026, 3+ protein
24-Hour urine protein excretion

15 g/24 h

A photomicrograph of the urine sediment under polarized light microscopy is showing maltese cross .

Which of the following is the most likely diagnosis?

A Focal segmental glomerulosclerosis
B Membranoproliferative glomerulonephritis
C Membranous nephropathy
D Minimal change glomerulopathy
E Systemic lupus erythematosus nephritis
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  #2  
Old 06-04-2012
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Membranous nephropathy most common cause of nephrotic syn in adult.
note that Membranous nephropathy has hypocomplementemia only if it is due to SLE.
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Old 06-04-2012
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C Membranous nephropathy
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Old 06-05-2012
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ans is not membranous.
ans is minimal change disease.
what qbank say?
MCD is mcc in children and young adults!

i guess 21 is young adult and not old adult..lolZ
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Old 08-05-2012
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where to find a good source to really understand the concepts of glomerulonephritis? does anyone know?
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Old 08-05-2012
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Can some one explain why it's minimal change. Just is it because it's a nephrotic syndrome and minimal change is most common nephrotic syndrome?


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Old 08-05-2012
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Quote:
Originally Posted by Dr.Lacune View Post
where to find a good source to really understand the concepts of glomerulonephritis? does anyone know?
Medstudy.........
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Old 08-06-2012
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This Question is not straight forward ..Just because minimal change NS is MC.How can it be the answer .No clue in the question direct int to that..
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Old 02-14-2013
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D Minimal change glomerulopathy
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Old 03-25-2013
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minimal change because it appear as Maltese cross
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Old 03-27-2013
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Default this is from NEJM

“Maltese Crosses” in the Nephrotic Syndrome

A 66-year-old man presented with edema, which had developed over the previous month. The urinary sediment showed fatty casts (Panel A), with typical “Maltese crosses” under polarized light (Panel B), and was otherwise unremarkable, with no sign of nephritis. Laboratory evaluation revealed hypoalbuminemia (2.2 g of albumin per deciliter), hypercholesterolemia (369 mg of cholesterol per deciliter [9.5 mmol per liter]), and a serum creatinine level of 1.0 mg per deciliter (88 μmol per liter); a spot urine sample showed a protein-to-creatinine ratio of 13. A diagnosis of idiopathic membranous nephropathy was made on the basis of a renal biopsy and clinical findings. The appearance of Maltese crosses in the sediment is due to the birefringence of the lipid droplets, which consist mainly of cholesterol esters. A finding of this physicochemical phenomenon can prove useful in the diagnosis of the nephrotic syndrome. The patient was treated with prednisone and cyclophosphamide. The proteinuria showed a steady decline, and after 9 months, there was complete remission, with resolution of all laboratory abnormalities. The immunosuppressive medications were tapered and then discontinued,
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