generalised swelling

Question 1

Main causes of generalised swelling

Answer 1

Nephritis
Nephrosis
Allergic reaction
Urticaria, angioedema 
Other causes of hypoalbuminaemia

Question 2

Complications of nephrotic and nephritic syndromes

Answer 2

Nephrotic syndrome Acute - Hypovolemia, as it’s, pleural effusions and peritonitis
Nephritic acute renal failure, pulmonary oedema, Hypertensive encephalopathy

Question 3

Nephrotic syndrome

Answer 3

Lots of protein in urine - more then 3.5g/HR
Low albuminaemia
Oedema
Hyperlipideamia due to liver trying to make protein

Presentation - oedema, in the morning around the eyelids and pitting oedema in legs, may develop to wt gain, as cite and pleural effusion in time.

Question 4

Nephritic syndrome

Answer 4

Haematuria
Proteinuria small amount
Hypertension
Low urine volume - less then 300ml/day

Presentation - Haematuria - cola coloured urine typically 1-2 weeks after a throat infections or 3-6 was after a skin infection. May be malaise, oedema, loin pain and headache or be asymptomatic.

Ix - throat swab, anti streptolysin O titre.
Tx - 10 day course of penicillin , fluid balance, renal function. Salt and fluid restriction and HTN control.

Question 5

Tx of nephrotic syndrome

Answer 5

Steroids - prednisolone
Fluid restriction
Low salt diet
Prophylactic penicillin
Education on relapse

Question 6

Anaphylaxis

Answer 6

Rapid onset of severe systemic reaction
Specific Ig E triggers histamine release from mast cells
Angioedema and bronchospasm can compromise breathing causing hypoxia
Capillary lead can lead to shock
Tx - antihistamines, steroid and intramuscular adrenaline.

Question 7

How to differentiate nephritic and nephrotic on urinanalysis

Answer 7

Nephrotic - large protein no blood

Nephritic - Large blood little protein.