Purpura Nephritis Questionnaire

Name *:
Age *:
Email *:
Gender:Male Female
Q1:Who have purpura nephritis?
Q2:How long since purpura nephritis is found?
Q3:Do you know the cause of purpura nephritis?
Infections such as upper respiratory tract infection ,virus infection ,bacterial infection ,etc
Medicines such as antibiotics, sulfanilamide, isoniazid, captopril ,etc
Foods such as fish, shrimp crab, etc
Q4: What is the creatinine level?
Q5:What is the GFR level?
Q6:What symptoms the patient has? (click all that apply)
Proteinuria hematuria skin purpura joint swelling abdominal pain lymph node enlargement headache etc
Q7:Choose if the patient has any of the following early signs of kidney disease
Foams in urine
or proteinuria
Swelling in limbs
eyelids or ankles
Rising blood pressure
Increased night urination
Q8:What kind of treatments the patient has received? (click all that apply)
ACEI ARB cyclophosphamide methylprednisolone dialysis plasma exchange etc
What information would you like to be given? (please write what you want to know more in the box below)

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