BEX was a combination of Aspirin 420mg, Phenacetin 420mg and Caffeine 160mg---and was known as an APC powder. There were other popular brands like Vincents powders. Used and advertised widely to Australian housewives to treat pain and stress it was an over the counter formulation.

It caused analgesic nephropathy---specifically renal papillary necrosis.

Also caused upper urinary tract cancers which added to the case to remove it's sale.

If this information stressor you----"Have a cup of tea, a BEX and a lie down" and it will all be fine.

Henoch Schonlein purpura has been renamed IgA vasculitis. The IgA deposits in the small vessel walls of the kidney.

Renal involvement is seen in half of patients with Henoch Schonlein purpura.

Those with nephrotic syndrome lose a lot of protein in their urine so may present with pitting oedema, hypertension or even frothy urine (because of the protein).

Most commonly seen in young children.

All of these options occur in some patients with polycystic kidney disease. About 5% develop cerebral aneurysms, higher if someone else in their family has had one (about 15%).

Barry Humphries died recently with complications after a hip fracture. He fell whilst reaching for a book

An ascending urinary tract infection may cause pyelonephritis and even renal abscesses but is very unlikely to cause obstruction and hydronephrosis.

The 3 other options all can cause unilateral or bilateral obstruction of the ureters causing hydronephrosis on one or both sides.

Not surprisingly antibiotic regimes vary around the world. The ECI (Emergency Care Institiute) has a good summary of Australian guidelines.

Macroscopic haematuria, flank pain or a palpable mass are the most likely ways this cancer presents. Incidentally finding the mass on a CT is now becoming more common.

Stage 1 tumours have a 90% 5 year survival rate but a person with a Stage 4 tumour has only about a 5% 5 year survival.

From an Emergency Physician's point of view overdose of Ethylene Glycol (anti freeze) is important to remember. It causes deposits of Calcium Oxalate crystals in multiple parts of the body, including the kidneys.

Where demand outstrips demands and people are desperate a black economy is created.