Get Answer: Year Been Well Question Guide

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What This Question Is About

This question relates to year been well and requires a structured academic response.

How to Approach This Question

Structure your response with introduction, analysis, and conclusion.

Key Explanation

This topic involves year been well. A strong answer should include explanation, application, and examples.

Original Question

HPI: A 13-year-old boy had been well until 4 weeks before admission, when he developed a cough, periorbital edema, ankle swelling, headaches, and upper abdominal discomfort. On admission, he was febrile with facial and ankle edema; there were generalized, superficial lymphadenopathy; numerous adventitial sounds in the lungs; and mild hypertension (BP 140/110). His hemoglobin was 72 g/l with a normal white-cell count and an erythrocyte sedimentation rate (ESR) of 137 mm/h. His blood urea was high (27.5 mmol/l) with a low serum bicarbonate (13.6 mmol/l) and serum albumin (19 g/l). His creatinine clearance was 45 ml/min/m2 with urinary protein loss of 6.7 g/day. His serum CH50 was low (14 U/ml; NR 25-45), as was his C3 level (0.20 g/l; NR 0.8-1.4); his C4 level was normal (0.30 g/l; NR 0.2-0.4). A chest x-ray showed several rounded opacities in both lungs. These were presumed to be infective and treated with amoxycillin and flucloxacillin with resolution of the radiological findings. The association of a low C3 with acute glomerulonephritis suggested acute poststreptococcal disease as the most likely diagnosis, although no streptococci were isolated and streptococcal antibodies were not raised. Over the following 3 weeks, his blood urea fell but the proteinuria and hypertension persisted.

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