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APSGN Screening — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

HardCommunity & Indigenous HealthAPSGN ScreeningRACP Paediatrics

A 7-year-old Aboriginal child developed post-streptococcal glomerulonephritis after impetigo. At eight-week review, oedema and macroscopic haematuria have resolved, but C3 remains low, creatinine is above baseline and blood pressure is at the 97th centile. What should happen next?

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Reveal the answer and explanation

Correct answer: D — Discuss urgently with paediatric nephrology and evaluate an atypical course

Explanation lettering: C = shown as A · D = shown as B · A = shown as C · E = shown as D · B = shown as E

E is correct because persistent hypocomplementaemia, abnormal renal function and hypertension at eight weeks are atypical and meet criteria for nephrology discussion, including consideration of another glomerulopathy or biopsy. A misapplies the reassurance about isolated microscopic haematuria to multiple red flags. B creates a prolonged unsafe delay. C skin health remains important but does not explain away renal abnormalities. D may worsen hypertension or fluid overload and does not address the diagnosis. The item respects the higher burden and long-term kidney risk of PSGN in Aboriginal and Torres Strait Islander children without assuming ethnicity itself determines management.

Reference: Royal Children’s Hospital Melbourne, post-streptococcal glomerulonephritis: https://www.rch.org.au/clinicalguide/guideline_index/Post-streptococcal_glomerulonephritis_%28PSGN%29/