OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is minimal change disease. While this may seem a odd practice, it is useful to see multiple examples of how minimal change disease will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a tradition question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
QUESTION EXAMPLES
Question # 1
A 5 year old boy has periorbital and pedal edema, as well as ascites. This all occurred 8 days after an upper respiratory tract infection. The patient’s breath sounds are diminished on the right side of his chest. HIs liver is palpable, and there is pitting edema appreciated on the lower extremities bilaterally. Lab studies are collected and are shown below:
- Hematocrit: 45%
- Urea nitrogen: 7 mg/dL
- Creatinine: 0.6 mg/dL
A urinalysis shows 4+ protein, and no occult blood, WBCs, RBCS, casts, glucose, or ketones. What is the most likely diagnosis?
Question # 2
A 4 year old boy is brought to the clinic with a 1 week history of edema over the face, arms, and legs. His mother believes that this swelling is worsening with time. The patient is not taking any medications currently, his vaccinations are up to date, he has no known allergies, and his past medical history is non-contributory. His vital signs are as follows: temperature 98.1°F, blood pressure 115/80 mm Hg, pulse 88/min, respirations 17/min. Physical examination reveals periorbital edema and 2+ pretibial pitting edema. The rest of the physical exam is unremarkable. Lab studies are ordered, and the results are below:
Serum
- Sodium: 141 mEq/L
- Creatinine: 0.7 mg/dL
- Albumin: 2.1 g/dL **
Urine:
- Protein: 4+ protein **
- Other: No red blood cells **
Given the above, what diagnosis may explain this presentation?
Explanation: young child + periorbital/lower leg edema + low albumin + proteinuria + no hematuria = minimal change disease
Question # 3
A 5 year old boy is brought to the clinic because he has not been feeling well for the past week. He has been feeling “swollen” all over, is tired, and also complains of abodminla pain. This patient’s past medical history is otherwise unremarkable, he has no allergies, and all of his immunizations are up to date. His temperature is 98.7°F, blood pressure is 90/55 mm Hg, and pulse is 91/min. A physical exam reveals the presence of periorbital edema, and 2+ pitting pretrial edema. The patient’s scrotum is also swollen but is not tender. The rest of the physical exam is non-contributory. A urinalysis is performed and the results are shown below:
- Protein: 4+**
- Blood” negative**
- Casts: negative
- Crystals: negative
What is a likely diagnosis in this patient?
Explanation: young child + periorbital/lower leg edema + proteinuria + no hematuria = minimal change disease
Page Updated: 11.15.2016