So, today's battles are:
5.1 nephrotic syndrome
5.2 renal vein thrombosis
5.3 IgA glomerulonephritis
5.4 acute epiglottis
Battle 5.1: Nephrotic syndrome
Nephrotic syndrome is a classic triad of:
- >3g proteinuria
- hypoalbuminaemia <25 and
80% of the time it is associated with glomerulonephritis, a fiendishly complex set of conditions.
The rest of the time its possible causes are many and varied:
- diabetes mellitus
- gold/penicillamine/NSAIDS/captopril/interferon alpha/heroin
- accelerated hypertension
- sickle cell disease
- rarely visico-ureteric reflux
Happily I do have a way of remembering the potential complications of nephrotic syndrome, which is good since sneaky MRCP examiners may be trying to get you to guess nephrotic syndrome from a description of the complications alongside part of the classic triad.
My mnemoric is BOB, I HIT HIM:
- B12 deficiency
- Thrombosis (including renal vein thrombosis)
- Iron deficiency
Treatment for nephrotic syndrome is to restrict salt, treat the cause, prophylactic heparin, treat any hypertension and potentially give furosemide or ACE-i.
On to 5.2... renal vein thrombosis