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Child with generalised swelling
| Clinical Discipline(s)/Organ System(s) Genitourinary System, Paediatrics, Renal Medicine | Progress Test Topic(s) Child health, Renal |
Description
A three year old Tongan boy is brought to clinic with periorbital swelling. His mother has noticed it over 5 days when he gets up in the morning. There is swelling around his ankles and more recently she has noted swelling of his scrotum.
Progress Test-Type Questions: Question 1 | Question 2 | Question 3Applied Science for Medicine
- Anatomy and physiology of urinary tract
- Pathology of kidney disease
- Microbiology of Streptococcus pyogenes and non suppurative complications of group A streptococcal infection
- Immunopathology of post-streptococcal disease
- Causes of end-stage renal failure
- Anatomy and physiology of urinary tract
- Pathology of kidney disease
- Microbiology of Streptococcus pyogenes and non suppurative complications of group A streptococcal infection
- Immunopathology of post-streptococcal disease
- Causes of end-stage renal failure
Clinical and Communication Skills
- Elicit a history, including ingestion history (nephrotoxins, potential allergens)
- Differentiation of nephritic and nephrotic syndromes using history, physical examination and urinalysis
- Recognition and management of anaphylaxis
- Establish a relationship with the patient and family/whānau
- Consider health literacy needs of patient and family/whānau
- Elicit a history, including ingestion history (nephrotoxins, potential allergens)
- Differentiation of nephritic and nephrotic syndromes using history, physical examination and urinalysis
- Recognition and management of anaphylaxis
- Establish a relationship with the patient and family/whānau
- Consider health literacy needs of patient and family/whānau
Personal and Professional Skills
- Communicate empathetically with child and caregivers
- Communicate with the patient and family/whānau in a way that ensures they have sufficient knowledge and understanding to be able to make informed decisions and give informed consent
- Consideration of patient and family/whānau cultural and spiritual support needs
- Communicate empathetically with child and caregivers
- Communicate with the patient and family/whānau in a way that ensures they have sufficient knowledge and understanding to be able to make informed decisions and give informed consent
- Consideration of patient and family/whānau cultural and spiritual support needs
Hauora Māori
- Incidence of nephritic, nephrotic syndromes and renal disease unequally affecting Māori
- Awareness of organ donation issues within a Māori cultural context
- Awareness of Whānau dynamics (who is/are carers)
- Competency in engaging in a family/whānau meeting if required
- Impact of illness on whānau employment/income/social resources
- Incidence of nephritic, nephrotic syndromes and renal disease unequally affecting Māori
- Awareness of organ donation issues within a Māori cultural context
- Awareness of Whānau dynamics (who is/are carers)
- Competency in engaging in a family/whānau meeting if required
- Impact of illness on whānau employment/income/social resources
Population Health
- Skin infections common in New Zealand and epidemiology of post-streptococcal nephritis
- Dialysis and transplantation in New Zealand; access to services
- Skin infections common in New Zealand and epidemiology of post-streptococcal nephritis
- Dialysis and transplantation in New Zealand; access to services
Conditions to be considered relating to this scenario
Common
nephrotic syndrome, glomerulonephritis (acute post-streptococcal GN), allergic reaction, angioedema
nephrotic syndrome, glomerulonephritis (acute post-streptococcal GN), allergic reaction, angioedema
Less common but 'important not to miss'
other causes of hypoalbuminaemia, anaphylaxis
other causes of hypoalbuminaemia, anaphylaxis
Uncommon
intestinal lymphangiectasia
intestinal lymphangiectasia
