Students Name: CLIPP Case#:

I. Epidemiology/Patient Profile:
II. Prioritized Problem Cues from istory and pysi!al e"am #do not in!lude lab$ "%ray$ or oter diagnosti! test results ere&
'ier ( #!ontribute most to te ))*& 'ier + 'ier ,
-ilateral periorbital edema .n and off !olds sin!e )e!ember In!reased number of naps
/!ute 0eigt gain 1orsens after sleeping Normal nigt sleep
/nasar!a in fa!e$ abdomen$ and legs 2sluggis3
)istended abdomen )e!reased appetite
4 fluid 0a5e Clotes feel too tigt around 0aist
Pitting an6le edema Immunization 7') No abnormal eart sounds
No 6no0n allergies No fe5er
Criti!al Negati5es #(%,&: Not impro5ed 0/ -enadryl or eye drops Eyes not pruriti!$ in8e!ted$ or draining
III. Problem Statement
I9. )ifferential )iagnosis
'ier ( #most li6ely& 'ier + #moderately li6ely& 'ier , #least li6ely&
Neproti! syndrome : minimal !ange dz Congesti5e eart failure /llergi! rinitis
;epati! failure Sinusitis
<lomerulonepritis /llergi! rea!tion
Pyelonepritis -ilateral periorbital !ellulitis
9. E"planation of )iagnosti! Plan ##in!luding tests$ labs$ imaging studies$ et!.& and 'reatment Plan:
I a5e adered to te onor system: *====>osua ?ap$ @S,===================
#Students Signature&
Case Analysis Form LLU Pediatric Clerkship
Joshua Yap
31
5yo female with bilateral periorbital swelling x10days
5yo female with bilateral periorbital edema and fatigue. Pt has also noticed an increase in girth despite decreased appetite.
Bilateral periorbital swelling has been present for 10 days not related to recent colds. welling worsens after sleeping. !oes not
impro"e with Benadryl or eye drops. #o associated pruritis$ in%ection$ or drainage.
Pt has been &sluggish' and re(uiring more naps.
)n physical exam pt shows generali*ed anasarca and +fluid wa"e
,- to loo. for proteinuria
/0P w1 234 to assess renal and hepatic function
/B/ to r1o fatigue differential
/3 and /5 complement le"els to r1o glomerulonephritis
2ipid panel to wor.up nephrotic syndrome
6f it is primary nephrotic syndrome7 treatment should start with corticosteroid for the underlying pathology. 3or symptomatic
anasarca$ pt can be gi"en 68 furosemide + 95: albumin and be restricted to 1500;9000mg of sodium daily