a pt 11/2yr old suffering from fever sweling body abdomen.usg shows ascitis mild hepatomegaly blood urea 60 proetin 9.2 hb 8.2 urine protien +++your diagonosis please

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POSSIBLY... ACUTE .. NEPHROTIC SYNDROME ADVISABLE... USG.... CHEST. AND .. ABDOMEN X. RAY..... CHEST

THANKS A. LOT DR@. ANIL. KUMAR. JI
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Nephrotic syndrome going to CKD, Protein 9.2 (?gm) does not fit in . RFT, LFT, PROTEIN ELECTROPHORESIS, ascitis tap analysis, Abdominal Ultrasound, kidney biopsy needed to have complete diagnosis Nephrologist opinion with all results

1st DD is nephrotic syndrome. Ascitic tap is distress present, IV albumin, oral antibiotics, prednisolone, lasix, salt restrictions, intake output monitoring,

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Nephrotic syndrome • Additional Investigations- Urine spot protein creatinine ratio and Serum cholesterol. Serum urea and Sr. creatinine. Urine culture (since fever +), Sr. Albumin and Total protein • T/t -- After culture report comes, start Prednisolone @ 2 mg/kg/day in single/divided doses PO. Inj Furosemide (since massive edema/ascitis with resp difficulty +). Consider Inj. Albumin IV if sr. Albumin very low.

nephrotic syndrome But since there is hepatomegaly with fever hence infection is to be look for Bul and sr creatinine suggest child is in renal failure.proteinurea is +++and substitution of protein Huge ascitis needs constant tapping If output is poor than think of peritoneal dialysis Iv antibiotics like Ceftriaxozone and tazobactum

Avoid nephrotoxic drugs.. dose adjustments according to creatinine clearence if antibiotics are required..
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Ac nephritic nephrotic syndrome

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Nephrotic Syndrome.. why proteins are 9.2? Looks typo mistake.. Dont drain as sudden decompression may agrevate hypoproteinaemia and ascites with pleural effussion may be dangerous.. Measure S cholesterol and RFTs and start Prednisolone with BP, urine output monitoring..

NEPHROTIC syndrome, X-RAY chest PA view, USG of whole ABDOMEN

Nephrotic syndrome. Get 24 hours urine protein/ serum albumin/lipid profie. Rule out spontaneous bacterial peritonitis. Then start on 2mg/kg/day Prednisolone.

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