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 BOF 41

 

   

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BOF: 41

A 24-year-old male is admitted with a history of swelling of his lower limbs and facial swelling. On examination he has pitting oedema of his lower limbs and swelling of his eyelids. Blood pressure 130/80

Urinalysis:

Protein ++++

Blood negative

Investigations:

Sodium 138 mmol/L

Potassium 4.5 mmol /L

Urea 8.4 mmol/L

Creatinine 107 mmol/L

Albumin 21 g/L

24-hour urine protein 5.2 g

Renal biopsy show normal appearances on light microscopy.

Electron microscopy shows podocyte effacement

The patient is treated with steroids and diuretics

A week later the patient complains of pain in his loins

Repeat investigations show

Urine

Protein ++++

Blood +++

Blood

Urea 32 mmol /L

Creatinine 200 mmol/L

In this patient which of the following is most likely to reduce the cause of the complication that has occurred?

a)      ACE inhibitor

b)      Loop diuretic

c)      Aldosterone antagonist

d)      High protein diet

e)      Dialysis

 

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