29082017

A 10 /yr old girl presented in outpatient department with left flank pain of 2weeks duration,  progressive abdominal mass of a week duration and weight loss of a week duration.
Notable on examination are  evidences of weight loss and a tender,  nodular mass on the right flank,

a)  mention three diffential diagnosis for her condition.

B)  the girl was noticed to be unable  to use are lower limbs while being investigated  and the Abdominal Ultrasonography showed the mass to originate from the left kidney, what is your most likely diagnosis at this point?

C) Discuss four investigations  relevant to this diagnosis.

D) What are the risk factors to this condition?

E) Mention 5 prognostic factors in this condition.

F) What four complications may occur?

G) highlight  the stages of this condition.


A four year old girl was referred to you from a peripheral hospital  with history of Fever of ten days duration, vomiting and diarrhoea of week duration,  he was said to have had reduced urine output for two days though urine color was Amber, there was also facial and pedal edema.
Examination  revealed  an acutely ill looking child, Febrile (temperature  is 38.7centigrade) in mild respiratory distress, has pedal edema and facial puffiness, weight is 14kg.
Urine output is 0.3mls/kg/hr in the first 24hrs of admission
Serum  creatinine is is 6mg/dl.
Potassium  5.4mmol/l.
Urea 20mg/dl.

a)  What is your diagnosis?

b ) explain your initial fluid  regimen to your nurses.

c)  list ten causes of this condition.

d) Explain the pathophysiology of any three complications that may develop in this patient.

E)  what is the place dopamine in the management of this patient?

F)  Explain the term disequilibrum syndrome to your registrars.