An adult girl is brought to the physician because of generalized fatigue and dark urine for 1 week. Four weeks ago, she was treated with topical mupirocin for a skin infection. Medical history is otherwise unremarkable and she takes no routine medications. Her temperature is 37°C (98.6°F), pulse is 90/min, respirations are 14/min, and blood pressure is 132/89 mm Hg. Examination shows periorbital and 1+ pretibial edema bilaterally. The remainder of the examination shows no abnormalities. Laboratory studies show: decreased C3 levels, elevated antistreptolysin O titer and microscopic hematuria. Which of the following patient characteristics is most likely to indicate a poor long-term prognosis?

Question

Quizplus · Accepted Answer

Eductional Objective: Poststreptococcal glomerulonephritis presents with edema, hypertension, and hematuria after a streptococcal infection.  Most children recover completely, but adult patients have a relatively poor prognosis and higher risk of chronic hypertension and renal insufficiency.

An Adult Girl Is Brought to the Physician Because of Generalized