A 15 kg child has a urine output of 360 mL during the past 12 hours. Calculate the child’s urine output in mL/kg/hour for this period of time. (Do not enter units).

Choice A reason:

Facial edema is a common clinical manifestation of nephrotic syndrome in children. This occurs due to the retention of fluid in the tissues, which is a result of the kidneys leaking protein into the urine (proteinuria). The loss of protein reduces the oncotic pressure in the blood vessels, leading to fluid accumulation in the interstitial spaces, particularly noticeable around the eyes and face.

Choice B Reason:

Cloudy smoky brown-colored urine is not typically associated with nephrotic syndrome. This symptom is more indicative of hematuria, which is the presence of blood in the urine. Hematuria is more commonly seen in conditions such as glomerulonephritis rather than nephrotic syndrome.

Choice C Reason:

Weight loss is not a characteristic symptom of nephrotic syndrome. In fact, children with nephrotic syndrome often experience weight gain due to fluid retention. The accumulation of fluid in the body can lead to an increase in weight, rather than a loss.

Choice D Reason:

Frothy appearing urine is a hallmark sign of nephrotic syndrome. The frothiness is due to the high levels of protein being excreted in the urine (proteinuria). When protein is present in the urine, it can cause the urine to appear foamy or frothy.

The correct answer is d. Frequent serial casting is tried first

Choice A reason:

Infants do not outgrow clubfoot on their own. Without treatment, the condition can lead to significant disability and difficulty walking. Early intervention is crucial to correct the deformity and ensure proper foot function.

Choice B Reason:

Surgical intervention is not the first line of treatment for mild cases of clubfoot. Surgery is typically reserved for severe cases or when nonsurgical methods, such as casting, have failed. The goal is to correct the foot’s position using less invasive methods whenever possible.

Choice C Reason:

Traction with foot manipulation is not a standard treatment for clubfoot. The primary nonsurgical treatment involves the Ponseti method, which includes gentle manipulation and serial casting to gradually correct the foot’s position.

Choice D Reason:

Frequent serial casting, known as the Ponseti method, is the first line of treatment for clubfoot. This method involves weekly manipulation and casting of the foot to gradually move it into the correct position. It is highly effective and is the preferred initial treatment for most cases of clubfoot.