EXAMINATION 3
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INTERPRETATION DATA -A
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FOLLOWED BY DATA- B
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DATA - A:
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A 3 years old girl presented with 3 days history of puffy face, swollen abdomen and swollen legs. She is passing lesser urine and is running low grade fever. The urinalysis shows: flower girl wears in red
Color Normal
Albumin ++++
Pus cells 3-4/HPF
Hyaline casts 1-2/HPF

Q: What is abnormal ?
Q: Name the diagnosis?
Q: List two further investigations ?

DISCUSSION
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The main abnormality in this urinalysis is gross albuminuria, the hyaline casts being a normal finding.
The natural consequences of this loss will be hypoproteinemia leading to generalized body edema.

The probable diagnosis is nephrotic syndrome.

Two further investigations will be:

1. Timed- 24 hours urinary protein excretion or spot urine protein/creatinine ratio.

2. Measurement of total serum proteins including albumin/globulin ratio.

DATA - B
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The following are results of the investigations mentioned above:

1. Urinary protein/ creatinine ratio:
880 mg / 66 mg.

2. Serum total proteins: 3 grams %
Albumin: 0.9 grams %
Globulin: 2.1 grams %

Q: What are the abnormalities in these results ?
Q: How will you interpret them and name the diagnosis it leads to?
Q: Name the treatment of choice?
Q: Give prognosis?

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