Fabricated or Induced Illness Case 3

  1. 1. Question

    A 6-year-old boy comes into the ED with his mother. He was referred up by his GP with haematuria on dipstick sample of urine. His examination is unremarkable.

    Match the clinical finding or investigation result with the likely diagnosis.

    Sort elements
    • Urinary tract infection
    • Nephroblastoma (Wilms tumour)
    • Haemolytivc Uraemic Syndrome (HUS)
    • Henoch Schonlein Purpura (HSP)
    • Post-Streptococcal Glomerulonephritis
    • Raised Antistreptolysin O titre (ASOT)
      • Non-blanching spots on buttocks and legs
        • Bloody diarrhoea with impaired renal function
          • Abdominal mass and aniridia
            • Fever and painful micturition
            • 2. Question

              He returns 2 days later. Mum reports that he has abdominal pain. They have brought a urine sample from home. It shows ++++ protein on dipstick but no blood.

              Give 4 features on examination that you would look for in Nephrotic Syndrome.

            • 3. Question

              His weight is unchanged from his previous visit and his examination and repeat urine dipstick are both entirely normal.

              Give 2 reasons why this story is concerning for FII.

            • 4. Question

              While the Mum is out of the room the child tells you that “Mum put an egg in my wee”.

              Give 3 actions you should take.