12/6/2023 0 Comments Brisk capillary refillThe proteinuria in nephrotic syndrome is severe, exceeding 50 mg of excreted protein for every kilogram of body weight over 24 hours. The diagnostic criteria are marked proteinuria, generalized edema, hypoalbuminemia, and hyperlipidemia (with hypercholesterolemia). Nephrotic syndrome describes the collection of clinical and laboratory findings secondary to glomerular dysfunction, resulting in proteinuria. His corticosteroids are tapered off and he remains stable. His edema and proteinuria gradually resolve with treatment. He is followed as an outpatient clinically and by daily urine dipsticks. He is not ill enough to require hospitalization. His chemistry panel is remarkable for protein of 2 g/dL, serum albumin of 1.4 g/dL and cholesterol of 350 mg/dL. Urinalysis shows 4+ protein, and a specific gravity of 1.030. He has brisk capillary refill and 2+ pulses. The dorsal surfaces of his hands and feet have mild pitting edema. He has normal male genitalia with no scrotal edema. Abdomen is soft, non-tender, non-distended and without masses or shifting dullness. His lung exam shows good aeration, with no crackles or rhonchi. His eyes are non-injected, his conjunctiva are not edematous and his throat is not red. His face shows moderate periorbital edema. He is alert and cooperative with the examination. He has no other symptoms, but about two weeks ago had "a bad cold."Įxam: VS T 37, HR 90, RR 20, BP 92/55. His mother noticed this a few days ago and it seems to be worsening. Burns School of MedicineĪ previously well 5 year old male presents to your office with the chief complaint of facial puffiness. Case Based Pediatrics Chapter Case Based Pediatrics For Medical Students and Residentsĭepartment of Pediatrics, University of Hawaii John A.
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