3 Written questions
3 Multiple choice questions
- Palpable purpura on extensor surfaces of extremities + edema, arthralgia/arthritis, colicky abdominal pain with GI bleeding, acute scrotal pain, and/or renal dysfunction.
- "Sack of worms" feeling in one testicle. Generally not painful but may be tender with exercise. Occurs in 15% of males over 10 years old. Usually occurs on the left. May compromise fertility in which case surgery is indicated. Otherwise education and reassurance suffice.
- Accumulation of fluid in the tunica vaginalis around testicle. Transilluminates well. Small ones usually spontaneously resolve within a year. Larger ones may require surgery. Seen in 2% of male neonates.
2 True/False questions
Idiopathic hypercalciuria → 6 year old boy with puffy eyes in the morning and scrotal swelling at night. Labs show elevated triglycerides and cholesterol. Other findings will include: low albumin, decrease in plasma volume, proteinuria. Treatment may include monitoring and salt and water restriction.
Alport syndrome → Most common hereditary nephritis. Typical presentation is microscopic hematuria, especially after URI. 30 - 75% of cases are associated with progressive hearing loss. End stage renal failure is common by 20s - 30s. Usually x-linked. Ocular abnormalities may be seen, as well as rare leiomyomatosis of esophagus or respiratory tract.