TY - JOUR T1 - Answers to Epilogue questions: Troublesome Thai travels JF - Archives of disease in childhood - Education & practice edition JO - Arch Dis Child Educ Pract Ed SP - 166 LP - 167 DO - 10.1136/archdischild-2013-305874a VL - 100 IS - 3 AU - Ben Christopher Reynolds AU - Sophie Hambleton AU - Dieter Friedrich Dammann AU - Heather Joan Lambert AU - Marieke Emonts Y1 - 2015/06/01 UR - http://ep.bmj.com/content/100/3/166.abstract N2 - From questions on page 144 The answers to question 1 are C, E, H, I, J. Three broad categories of aetiologies can be considered for his renal impairment. NSAID use. Prerenal impairment secondary to dehydration, which should be readily reversible with volume replacement. Volume depletion alone can cause acute tubular necrosis. Infectious. Any patient returning from a tropical country with fever should have imported tropical illnesses high on the differential list. The activities of swimming in open water and eating partially cooked meat increased the likelihood of this patient having an imported tropical infective cause. Renal involvement is a recognised feature of a wide number of tropical illnesses, including leptospirosis, malaria, typhoid, viral haemorrhagic fever and HIV.1 It may present as a PIGN, haemolytic uraemic syndrome (HUS), or with prerenal failure secondary to the diarrhoeal element. In the case above, a recent outbreak of dengue had occurred in the region, prompting this as a possible diagnosis. Information on local bacterial epidemiology can be useful in pointing towards a diagnosis. Considering the options above, malaria would be unlikely with negative films and clear urinalysis, HUS is excluded by the normal haemoglobin and platelets, PIGN again by the clear urinalysis. Rickettsia does not typically cause any … ER -