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מבחן גמר בילדים > נפרולוגיה > Flashcards

נפרולוגיה Flashcards

1
Q

when we will see RBC casts + protenuria> 100

A

Hematuria from the glomeruli

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2
Q

most common reason for hematuria and what is the definiton of hematuria?

A

hematuria = > 5RBC /HPF

most common reason- UTI

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3
Q

ddx for painful hematuria?

A

kidney cysts bleeding
pressure on kidney bein
stones in urinary tract

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4
Q

menagment of persistent asymptomatic isolated hematuria?

A

מעקב ל”ד ושתן כל 3 חודשים עד שההמטוריה נעלמת.

הפניה לנפרולוג- בהמטוריה מעל שנה / עדות לנפריטיס יל”ד וכדומה

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5
Q

Which kidney disease are a/w low complement levels?

A
  • Lupus nephritis (both C3-C4)
  • PSGN- C3
  • MPGN- C3
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6
Q

What is the most common reason for persistent protenuria in kids? and how we dgx?

A

orthostatic protenuria
הפרשה מוגברת של חלבון בעמידה ובשכיבה כמויות תקינות.
אבחנה איסוף שתן בוקר (יהיה ללא חלבון) במשך 3 יממות

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7
Q

מהו השלב הראשון בבירור של פרוטינוריה בילדים?

A

בדיקת שתן כללית של שתן ראשון של הבוקר

ממצא שכיח המופיע ב-10% מהילדים בזמן נטילת דגימת שתן אקראית

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8
Q

Triad of nephritis syndrome?

A

Hematuria
protenuria < 3 gr
HTN

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9
Q

Which disease is close related to Alport syndrome?
and present with
מיקרוהמטוריה לסירוגין ומאקרוהמטוריה בזמן מחלת חום

A

Thin BM disease
המטוריה משפחתית שפירה

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10
Q

Alport Syndrome
inheritance?
mutation?
Dgx?

A

X-linked 85%
mutation in collagen type 4- found in BM, eyes.

Triad:
1. מיקרוהמטוריה ומאקרואמטוריה 1-2 ימים לאחר מחלת URTI
2. פגיעה בראייה- ant. lenticonus
3. פגיעה בשמיעה

Dgx- family Hx, שתן לכללית לקרוב משפיה דרגה 1, בדיקות ראיה ושמיעה.

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11
Q

Tx and prognosis of Alport syndrome?

A

Tx- ACEi
prognosis - 75% ESDR < age 30

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12
Q

What is the most common type of ** Chronic** GN in kids?

A

IgA nephropathy

macrohematuria after infection

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13
Q

Tx for IgA nephropathy

A

ARBs/ ACEi - low BP and protenuria
consider Steroids

chence of ESRD- 30%

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14
Q

Post Strep GN
ages and timeline

A

7-14 days after pharyngitis
or
3-6 wks after impetigo

age mainly 5-12, more in boys

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15
Q

Risk of PSGN?

A
  • Lung edema
  • encephalopathy
  • CHG
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16
Q

Labs result of PSGN

and how we dgx PSGN?

A

low C3
hematuria
RBC Casts
protinurea

Dgx- lab and clinical presentation + prove GAS infection (also or culture)

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17
Q

Tx for PSGN?

prognosis?

A

diuretics + lowering BP medications
penecillin for 10d- to eradicate nephrogenic species.

prognosis- 95% full recovery. microhematuria can last for 1-2 yrs

18
Q

What is the most common etiology for primary nephrotic syndrome?

A

minimal change disease

19
Q

Which complications are a/w nephropaty snydrome

A
  • hypercoagulability- loss of protein C + S in urine
  • Infection with capsulated pathogens
  • hypovulemia- use of diuretics
20
Q

Which infections are a/w congenital nephrotic syndrome?

התייצגות בלידה / ב-3 חודשים הראשונים

A
  • intra uterine infections - TORCHeS
  • mercury exposure
  • SLE
21
Q

Dgx of miniaml change disease?

A

איחוי רגלי הפודוציטים במיקרוסקופ אלקטרונים

22
Q

Tx for minimal change disease and when we will start it:

first and second line tx

A

kids < 8 yrs old - can start Tx w/o biopsy

Tx:
1st line- high dose steroids- resuce reccurent
2nd line- cyclosporine/ cyclophospamis

23
Q

what we have to do prior Tx of minimal change disease?

A

pneumoccoc vaccine + mentuo test

24
Q

chance of reccurence of minimal change disease?

A

80%

25
Q

In minimal change disease

when its indicate to perform kidney biopsy?

A
  • age > 12
  • Full course of steroids without satisfying reaction (8wks)
  • a-typical presentation of MCD- like low C3, gross hematuria, age < 1 or above 12
26
Q

RPGN
Tx?
presentation?

A

Tx- steroids
presentation- combine nephritic + nephrotic syndrome with acute progressive renal insuff.

biopsy- סהרונים

27
Q

other pathogens for HUS?

A

E.coli 157
Shigella
pneumoccoc
Compylobacter

28
Q

Triad of HUS?

A
  • Hemolytic anemia (MAHA)
  • AKI
  • thrombocytopenia
29
Q

Complication of HUS?

A

Seizures, severe Encephalopathy.

if present also with fever its TTP

also:
pancreatitis
CHF
intestine perforation

30
Q

What is the Tx in HUS + neurologic involvment?

A

Plasmapheresis (like TTP)

in HUS- supportive and consider dialysis

31
Q

Oliguria
urine NA > 30
BUN/Cr < 20
hyperkalemia
hyperuricemia
hyperphophatemia
hyponathremia
hypocalcemia
metabolic acidosis

with muddy brown casts

A

ATN

32
Q

RTA acid balance?

A

Non AG metabolic acidosis hyperchloremic

33
Q

placed in the nephron:
RTA1
RTA2
RTA4

A

RTA2- PCT&raquo_space; Fanconi syn.
RTA1&raquo_space; DCT
RTA4&raquo_space; CD - hyperkalemia. aldosterone deff. or resistant to it

34
Q

Bertter Syndrome

elctrolyte disbalance

A

בססת מטבולית
היפוקלמיה
היפרקלצאוריה
אבדן מלח
כלור גבוה בשתן (בשונה מהקאות- כלור נמוך)

like fusid

34
Q

What is the presentation of Classical Bartter syndrome

A

chilhhod
FTT and recurent dehydration episodes

35
Q

most common primery tumor in kidney in kids?

A

Wilms tumor- Nephroblastoma

(second most common of all- after neuroblastoma)

can be seen in beckwith - wendhem syndrome
WAGR syndrome, Deny-drash syndrome

36
Q

Clinical presentation of wilms tumor?

A

Abdominal mass
HTN
hematuria

37
Q

Which kidney condition is highly a/w renal vein thrombosis?

A

Membranous nephropathy

38
Q

Clinical menefestation of Renal vein thrombosis?

A

Sudden onset hematuria and unilateral כאב מותניים

Tx- mainly supportive

39
Q

indication for dialysis?

A

AEIOU
A- Acidosis PH < 7.1
E- Electrolyte- Hyperkalemia persistent
I- intoxication
O- overlaod fluid refactory to Tx
U- uremia - enephalopathy or pericarditis

also anauriya or oligureya

40
Q

What are the 2 options of Tx for Vesiculo-urethral reflux

A
  1. שמרני- אנטיביוטיקה מניעתית, עד שהרפלוקס חולף / שהסיכון פוחת
  2. ניתוחי- בכשלון טיפול שמרני / רפלוקס קשה
41
Q

Posterior urethral valve
dgx ?

A

most Dgx in pre-natal phase with US- Bi-lateral hydronephrosis with enlrage bladder

מבחן גמר בילדים (23 decks)

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