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Simmons NURP 503 Exam 1 > 2: Peds Proteinuria > Flashcards

2: Peds Proteinuria Flashcards

1
Q

Isolated or transient proteinuria?

Persistent asymptomatic proteinuria

A

Isolated

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2
Q

What is orthostatic proteinuria?

A

Pt excretes normal amounts of protein while lying down, but abnormal amounts when upright.

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3
Q

Isolated or transient proteinuria?

Cold/infx/seizure/CHF

A

Transient (functional)

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4
Q

Refer to nephrology, yes or no?

Orthostatic proteinuria.

A

No

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5
Q

Refer to nephrology, yes or no?

Nephrotic levels of protein.

A

Yes

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6
Q

When proteinuria is significant enough to cause HYPOproteinemia, _____ occurs.

A

systemic edema

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7
Q

How is orthostatic proteinuria diagnosed?

A

Compare first morning void with UA obtained during the day. If <1+, no further workup is needed. Repeat urine for 3 months up to 1 year. This is a benign condition.

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8
Q

Refer to nephrology, yes or no?

Elevated BUN, creatinine, or BP.

A

Yes

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9
Q

Isolated or transient proteinuria?

Exercise induced

A

Transient (functional)

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10
Q

If proteinuria is present, what other diagnostics should be considered?

A 
CBC
Electrolytes, BUN, creatinine
Albumin, total serum protein
Liver function tests
C3, C4
Cholesterol
Urine culture (rule out UTI)
Renal US, VCUG, radionuclide scans if indicated
ANA
ASO
Streptozyme
Hepatitis B
HIV
Tuberculosis
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11
Q

Refer to nephrology, yes or no?

Transient nonorthostatic proteinuria with no other complications.

A

No

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12
Q

T/F Fatigue, malaise, and pallor may be present with proteinuria.

A

True

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13
Q

Refer to nephrology, yes or no?

Family hx of renal failure, GN or sensorineural loss.

A

Yes

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14
Q

Refer to nephrology, yes or no?

Hematuria and proteinuria.

A

Yes

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15
Q

Urinalysis can be falsely positive or negative for protein based on _____ and _____.

A

pH

dilution

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16
Q

If protein is trace or 1+ and/or specific gravity is >1.105, then recheck monthly for _____ months.

A

4-6

17
Q

Peak incidence of proteinuria occurs in _____.

A

adolescence

18
Q

Isolated or transient proteinuria?

Orthostatic proteinuria

A

Isolated

19
Q

Isolated or transient proteinuria?

Stress-induced

A

Transient (functional)

20
Q

If first morning void shows 1+ protein, then proteinuria is not orthostatic. What are the next steps?

A

Perform 24-hr urine protein excretion test.
Or perform random spot protein/creatinine ratio.
If hematuria present, work up for nephritis.
Close follow-up is essential.
Refer if persistent.

21
Q

Name 2 drugs that can cause pseudo-proteinuria.

A

Semisynthetic PCN

Benzalkonium chloride

22
Q

What family hx may be present with proteinuria (3)?

A

Deafness
Visual problems
Renal dz

23
Q

What is the origin of proteinuria?

A

Problems with glomerular filtration, tubular reabsorption, secretion, or both.

24
Q

If protein is >1+, check for _____. If not present, refer pt.

A

orthostatic proteinuria

25
Q

Refer to nephrology, yes or no?

Polyuria or oliguria.

A

Yes

26
Q

Refer to nephrology, yes or no?

Presence of RBC or WBC casts.

A

Yes

27
Q

Refer to nephrology, yes or no?

Persistent unexplained nonorthostatic proteinuria.

A

Yes

28
Q 
Refer to nephrology, yes or no?
Systemic complaints (joint pain, rashes, arthralgias).
A

Yes

29
Q

Isolated or transient proteinuria?

Fever induced

A

Transient (functional)

30
Q

What percent of school-age children have proteinuria on urine screening?

A

5-15%. Decreases to 0.1% if 4 consecutive urines counted.

31
Q

What is the most common type of proteinuria in children and adolescents?

A

Orthostatic Proteinuria
60% in children
75% in adolescents

32
Q

Normal protein:creatinine ratio:
2 years +
<2 years

A

2 years or older = <0.2

Under 2 years = <0.5

33
Q

What are the 4 classes of proteinuria?

A

Isolated
Transient (functional)
Glomerular
Tubulointerstitial

34
Q 
Levels of protein in urine:
Qualitative UA?
Qualitative USG?
Quantitative timed urine?
24-hour urine?
A

Qualitative UA 1+ abnormal
Qualitative USG >1.105 abnormal
Quantitative timed urine <4 mg/m2/hr normal
24-hour urine <150 mg/24 hr normal

35
Q

Name 7 red flags for renal dz.

A

Failure to thrive
Chronic anemia (normocytic, normochromic)
Complicated enuresis
Prolonged unexplained nausea and vomiting, inability to eat, weight loss
Hypotension
Unusual bone disease
Poor school performance

36
Q

Protein and creatinine can be done on _____ or _____ urine.

A

24-hour

spot

Simmons NURP 503 Exam 1 (34 decks)

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