3 Written questions
3 Multiple choice questions
- "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.
- 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.
- Often seen post strep infection. Common presentation is fatigue, cola-colored urine, and elevated blood pressure. Fluid intake should be restricted when oliguria is present.
2 True/False questions
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.
Bartter syndrome → Juxtaglomerular hyperplasia. Autosomal recessive. Causes hypokalemia, hypercalciuria, alkalosis, hyperaldosteronism, and hyerreninemia. Presents between 6-12 months with FTT, constipation, vomiting, polyuria, polydipsia. Treatment is fluid replacement, potassium correction, and nutrition.