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Question 4 I am confused over the use of a 'high-protein diet' in the management of nephrotic syndrome. You say it confers no advantage, but the Oxford Handbook of Clinical Medicine advocates its use and Davidson's Principles and Practice of Medicine says it is even dangerous as it could lead to renal damage. Which one should I choose, assuming I see the question in an MCQ?

Question 5 Is albumin infusion contraindicated in nephrotic syndrome? If not, then what are the indications?

Question 6 Listed under the drug causes of nephrotic syndrome, it has been stated that high doses of captopril can induce an immune-complexmediated membranous glomerulonephritis. If a patient with nephrotic syndrome has hypertension, is it detrimental to give captopril as a treatment for his hypertension? Could this exacerbate the patient's nephrotic syndrome?

Question 7 Please explain the pathophysiology of ascites in the nephrotic syndrome?

Question 8 Does the nephritic syndrome cause hyperkalaemia? I don't seem to be able to find a definitive answer in the textbooks that I have consulted.

Question 9 You say that the investigation of first choice for urinary tract infections (UTIs) in males or children, or recurrent UTIs in females, is intravenous urography (IVU); in Oxford Handbook of Clinical Medicine it is ultrasound (US). Which is best?

Question 10 1. Other than amoxicillin, what other orally administered drug is recommended for the treatment of a urinary tract infection (UTI) caused by enterococcus? 2. What is the recommended dosage for antibiotics in the prophylactic treatment of recurrent UTI in pregnancy? Is amoxicillin clavulanic acid safe to use during pregnancy?

Question 11 What is the advantage of intermittent self-catheterization over an indwelling catheter? How is bladder training done while on an indwelling catheter?

Question 12 Kindly tell me about the role of pulse wave velocity (PWV) in early diagnosis of arteriosclerosis. How is it useful in cardiac, diabetic and renal medicine?

Question 13 You say that no convincing evidence was found that chronic hyperuricaemia causes nephropathy and nor can it be corrected by allopurinol. However, some patients we see have high serum uric acid and creatinine, which both come down with allopurinol. Please comment.