Systemic paediatrics: IgA nephropathy: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Systemic paediatrics: IgA nephropathy

Sample item

A 10-year-old boy has painless gross haematuria that began on the first day of a sore throat, and has settled in 3 days. A similar episode occurred last year. He has no oedema, normal blood pressure and a normal serum C3. What is the most likely diagnosis?

AAlport syndromeBPost-streptococcal glomerulonephritisCIgA nephropathyDMinimal change disease

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. IgA nephropathy

IgA nephropathy characteristically presents with recurrent macroscopic haematuria 1 to 2 days after a mucosal infection (synpharyngitic), with normal complement. Post-streptococcal glomerulonephritis follows an infection by 1 to 3 weeks with low C3, oedema and hypertension. Biopsy shows mesangial IgA deposits.

Option by option

A. Alport syndrome
Alport syndrome has a family history, deafness and progressive renal disease.
B. Post-streptococcal glomerulonephritis
Post-streptococcal disease has a latent period of 1 to 3 weeks, low C3 and oedema.
C. IgA nephropathy (correct)
Correct. Haematuria at the time of infection with normal C3 and recurrence suggests IgA nephropathy.
D. Minimal change disease
Minimal change disease gives nephrotic proteinuria and oedema, not haematuria.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is C, IgA nephropathy. IgA nephropathy characteristically presents with recurrent macroscopic haematuria 1 to 2 days after a mucosal infection (synpharyngitic), with normal complement.

Why is "Alport syndrome" not the answer?

Alport syndrome has a family history, deafness and progressive renal disease.

Why is "Post-streptococcal glomerulonephritis" not the answer?

Post-streptococcal disease has a latent period of 1 to 3 weeks, low C3 and oedema.

Why is "Minimal change disease" not the answer?

Minimal change disease gives nephrotic proteinuria and oedema, not haematuria.

What concept does this question test?

It tests Systemic paediatrics: IgA nephropathy in Pediatrics. Post-streptococcal glomerulonephritis follows an infection by 1 to 3 weeks with low C3, oedema and hypertension. Biopsy shows mesangial IgA deposits.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic paediatrics: IgA nephropathy?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.