Proteinuria: diagnostic approach — formative SAQs

Question 1 (12 marks)

An adolescent girl is found to have 1+ protein on a dipstick at a school sports screen. She is asymptomatic, her blood pressure is at the 50th centile for age, sex and height, and she is otherwise well. ^[6]

a) State the first investigation you would perform and the reason it is done before any further testing. (3 marks) ^[2]

b) Her daytime dipsticks remain 1+ to 2+ over the next two weeks, but a first-morning void passed immediately on waking has a normal UPr/Cr. Name the diagnosis and outline the management and follow-up. (5 marks) ^[4]

c) Explain two ways in which the modern understanding of this diagnosis differs from the traditional teaching, and state the implication for follow-up. (4 marks) ^[5]