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3rd Year - Paediatrics > 13.1. Paediatric Nephrology - Nephritic / Nephrotic Syndrome > Flashcards

13.1. Paediatric Nephrology - Nephritic / Nephrotic Syndrome Flashcards

1
Q

What are the Common Paediatric Causes of:

  1. Proteinuria / Haematuria?
  2. Acute Kidney Injury?
  3. Chronic Kidney Injury?
A
  1. Glomerular Disease - Nephrotic / Nephritic Syndrome
  2. Haemolytic Uraemic Syndrome
  3. Developmental Anomalies - Reflex Nephroapthy
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2
Q

What is the Glomerular Filtration Rate in a:

  1. Neonate?
  2. 2 Year Old?
A
  1. 20-30ml/min/1.73m^2

2. 80-120ml/min/1.73m^2

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3
Q

What are the Different Cells of the Kidney, Related to Excretory Function?

A
  1. Endothelial Cell - Fenestrated
  2. Glomerular Basement Membrane
  3. Podocyte - Proteins
  4. Mesangial Cell - Structural Support embedded in the Glomerular Basement Membrane
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4
Q

What are the Common Acquired Glomerulopathies affecting the Epithelial Cells (Podocytes)?

A
  1. Minimal Change Disease (MCD)
  2. Focal Segmental Glomerulosclerosis (GSGS)
  3. Lupus
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5
Q

What are the Common Acquired Glomerulopathies affecting the Basement Membrane Cells?

A
  1. Membranous Glomerulopathy
  2. Membranoproliferative Glomerulonephritis (MPGN)
  3. Post-Infectious Glomerulonephritis (PIGN)
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6
Q

What are the Common Acquired Glomerulopathies affecting the Endothelial Cells?

A
  1. Infectious Associated Glomerulonephritis (PIGN)
  2. Haemolytic-Uraemic Syndrome
  3. Membranoproliferative Glomerulonephritis (MPGN)
  4. Lupus
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7
Q

What are the Common Acquired Glomerulopathies affecting the Mesangial Cells?

A
  1. Henoch-Schönlein Purpura (HSP)
  2. IgA Nephropathy
  3. Lupus
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8
Q

What is Altered in Congenital Glomerulopathy?

A
  1. Podocyte Cytoskeletal Integrity
  2. Basement Membrane Proteins
  3. Endothelial / Micro-vascular Integrity
    Note - This is Rare
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9
Q

What are the Features of Nephrotic Syndrome?

A
  1. Proteinuria - Protein 3+ / Blood 2+ (not Frank)
  2. Hypoalbuminaemia - Normal Creatinine
  3. Oedema
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10
Q

How is Proteinuria Tested for?

A
  1. Urinalysis - Dipstix
  2. Protein Creatinine Ratio
  3. 24 Hour Urine Collection
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11
Q

What are the Typical Features of Minimal Change Disease?

A
  1. Age - Most common in Children
  2. Blood Pressure
  3. Haematuira
  4. Normal Renal Function
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12
Q

What is the Treatment of Minimal Change Disease?

A
  1. Prednisolone (Steroids) - it is Steroid Sensitive

2. Immunosuppression - Steroid Resistant

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13
Q

What are the Causes of Steroid Resistant Nephrotic Syndrome?

A
  1. Idiopathic - Focal Segmental Glomerulosclerosis

2. Congenital

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14
Q

What are the Common Causes of Haematuria?

A
  1. Urinary Tract Infection
  2. Trauma
  3. Stones / Hypercalciuria
  4. Glomerulonephritis - Post-Infective / IgA / HSP / Membranoproliferative / Lupus Nephritis
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15
Q

What are the Features of Nephritic Syndrome?

A
  1. Haematuria and Proteinuria

2. Reduced Glomerular Filtration Rate - Oliguria / Fluid Overload / Hypertension

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16
Q

If Nephritic Syndrome is suspected, what Investigations would be done?

A
  1. Blood Workup - Creatinine / FBC / Albumin
  2. Urine Workup - Exclude UTI
  3. Renal Ultrasound
  4. Biopsy
17
Q

What are the Features of Acute Post-Infectious Glomerulonephritis:

  1. Aetiology?
  2. Investigations?
  3. Treatment?
A
  1. a) Age of Onset
  2. b) Cause - Usually Group A Strep.
  3. c) Self-Limiting
  4. Diagnosis Made by Bacterial Culture
  5. Treatment = Antibiotics +/- Diuretics
18
Q

What are the Features of IgA Nephroapthy:

  1. Aetiology?
  2. Clinical Features?
  3. Investigations?
  4. Treatment?
A
  1. a) Most Common Glomerulonephritis
  2. b) Occurs 1-2 Days after URTI
  3. Clinically:
  4. a) Recurrent Macroscopic Haematuria
  5. b) +/- Chronic Microscopic Haematuria
  6. c) Varying Degree of Proteinuria
  7. Diagnosed by Clinical Picture / Biopsy
  8. Treated with ACE Inhibitor
19
Q

What are the Clinical Features of Henoch-Scholein Purpura?

A

IgA Related Vasculitis:
1. Age of Onset - 5-15 Years Old
2. Palpable Purpura
3. One of: Abdominal Pain / Renal Involvement / Arthritis / Arthalgia / Biopsy (IgA Deposition)
4. 1-3 Days Post-Trigger - Viral URTI / Strep.
5. Lasts for 4-6 Weeks
Note - Nephritis caused by Mesangial Cell Injury

20
Q

What is the Treatment of Henoch-Scholein Purpura?

A
  1. Symptomatic - Joints / Abdomen
  2. Glucocorticoid Therapy - Help G.I.
  3. Immunosuppression
  4. Long-Term - Hypertension / Proteinuria Screening

3rd Year - Paediatrics (40 decks)

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