Week 6 Case B

RM a 6 year old male child was brought to SWU-MC for the first time with chief complaint of swelling in
the face, legs and scrotal area.

HPI:
1 week PTA, mother noted puffy eyelids of the patient, no consult was done. Condition was tolerated,
until a few days PTA aside from the puffy eyelids the patient had swelling of the lower extremities and
scrotal area. She also observed that the patient had decrease frequency of urination and later told her
that her urine looks like ice tea. Persistence of condition prompted admission.

PE: awake, afebrile, not in respiratory distress

BP: 140/ 80mmHg HR: 100bpm RR: 20cpm O2 sat: 98% at room air Wt: 25kg

Skin: + multiple skin lesion with yellowish brown crust on the lower extremities
HEENT: supple neck, anicteric sclera, (-) cervical lymphadenopathy, grade II tonsils non erythematous
C/L: clear breath sounds
CVS: no murmur
Abd: globular, soft, NABS
GUT: scrotal swelling, + transillumination
Ext: grade 2 pretibial edema, strong pulses

Questions:

1. What other pertinent information should be elicited in the history? Physical examination?
2. Discuss the approach to hematuria and proteinuria?
3. What are the appropriate laboratory examination that should be performed to establish the
diagnosis?
4. Identify the logical diagnosis/ differential diagnosis based on the signs and symptoms of the
given case
5. Discuss the primary impression/diagnosis of the given case as to
a. Pathogenesis
b. Clinical manifestation
c. Appropriate diagnostic examination to establish the diagnosis
d. Management
e. Prognosis and Prevention