Nephrology and Urology

Question 1

Tetrad of Henoch-Schönlein purpura

Answer 1

1) Rash - non-blanching petechial/ purpura in gravity dependent and trunk sparing
= leuckoclastic vasculitis (SMALL VESSEL)
2) Renal involvement
3) arthritis / arthralgia (oligoarthritis)
4) GI involvement (80%) - intussusception / ischaemia

Question 2

Percentage recurrence of HSP?

Answer 2

15-60% recurrence in 6 months

Question 3

What percentage of children with HSP develop CKD?

Answer 3

1-2%

Question 4

Describe histological findings of biopsy of HSP

Answer 4

IgA deposition, C3, fibrin, immune complexes

Question 5

Epidemiology of HSP

Answer 5

75% of cases in children under 10
Usually preceeded by viral URTI/ Strep throat 2 weeks prior
Peak incidence autumn/winter
Clusters in families

Question 6

What is renin?

- stimulated by and blocked by?

Answer 6

Hormone stimulated by low serum sodium (causes increased BP)

• Inhibited partially by B-blockers and high chloride
• Cortisol increases Na+ reabsorption –> Increased blood volume –> reduced renin released