Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nephrology > deck 2 > Flashcards

deck 2 Flashcards

1
Q

hyponatremic hypovolemia

A 
diarrhea
emesis
burns
third spacing
urine na - low (cause you are concentrating)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

hypervolemia hyponatremia

A 
CHF
nephrotic syndrome
renal failure
sepsis if leaky
decreased albumin from protein losing enteropathy
cirrhoses
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

euvolemic hyponatremia

A 
SIADH
water intoxication - psychogenic or dilute formula
glucose
hypothyroidism
glucocorticoid deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

8 month old baby with gastroenteritis. Na 160, Cl elevated, Bicarb 14, HR 220, BP 60/30. What is your initial management. Once stable what is your ongoing fluid management?

A 
ABCs 20 cc/kg NS
then ongoing fluid management once stable 
determine how long to correct Na over - 
initial Na 145-157 correct over 24 hours
158-170 over 48 hours
171 -183 72 hours
184-196 over 96 hours

correction rate 10-12 mmol/day
typically fluid D5 1/2 normal saline with 20 KCl
1.25-1.5 maintenance (because they are dehydrated)
check your sodium often

Change in Serum Sodium
= (Fluid Sodium - Serum Sodium) / (Total Body Water + 1)
Total Body Water = (Wt in kg * % Water)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

noctural enuresis

A

2 parents with enuresis, 75% chance of enuresis
causes for nocturnal enuresis:
delayed maturation in cortical mechanism
sleep disorders
OSA
severe constipation
Don’t make as much ADH at night

Motivational therapy – limited evidence, try it
Fluid restrict, void before bed, caffeine
If doesn’t work, conditioning therapy – 30-60%, curative
Alarm system, usually better in kids > 6-7
meds - symptomatic
1st line DDAVP
2nd oxybutinin
3rd imipramine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Struvite stone, which organism

A

proteus
foreign body
urinary stasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

protein in a teenage girl

A

1st test - 1st AM urine x 2 then move on to other tests

in general if 3+ on dipstick more likely to be a fixed proteinuria, more likely to be a glomerular or tubular issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

when do sperm die in torsion

A

4-6 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

painless testicular masses

A 
varicocele
hydrocele
spermatocele
inguinal hernia
idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

painful scrotal masses

A

epididymitis
testicular torsion/appendicular torsion
orchitis
trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

most common flank mass

A

hydronephrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

most common abdo mass

A

multicystic dysplastic kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

types of rhabdo

A
  1. exertional
  2. non trauma exertional - hyperthermia, metabolic
  3. non trauma non exertional - drugs, toxins, , infections
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is DMSA

A

functional and anatomical information
better visualizes focal renal parenchymal abnormalities
also can compare kidney function between the two
look for scarring and pyelo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is MAG3

A

look at obstructive and non obstructive hydronephrosis, as well as different function between the two kidneys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 things VCUG can tell you

A
  1. reflux
  2. PUV
  3. bladder shape and function
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Alport’s disease

A

X linked dominant in 85% the rest are different types
start on high frequency loss
eye stuff - anti - lento conus (eye stuff), macular flex, corneal erosion, anterior lenticonus is pathognomic for Alport’s
renal disease - hypertension
type 4 collagen
prognosis for boys: 15% by 15 years old, 75% by age 30, hearing loss is gradual
for ladies - mild in general, some can have findings later in life (milder)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Prognostic factors in Alport’s

A
  1. gross hematuria
  2. nephrotic syndrome
  3. on biopsy have prominent glomerular basement membrane thickening
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What percentage of patients with nocturnal enuresis will spontaneously improve each year?

A

15% per year

20
Q

Do acute hydroceles hurt?

A

might have discomfort, but should be okay and tolerate feedings

21
Q

Causes of HUS

A 
Infectious causes of HUS:
- E. coli, S. pneumo, Shigella , HIV 
Medications 
- chemo (cyclosporine and tacrolimus)
Genetic HUS
Any disease with microvascular disease
- lupus, HELLP, antiphospholid
22
Q

Places you can get organism

A 
uncooked meat
well water
contaminate vegetables
unpasteurized milk/apple cider 
petting farms 
(usually E. coli, sometimes shigella)
23
Q

What is the incidence of CNS involvement in HUS?

A

the majority have CNS involvement, most are mild - lethargy, irritability, non specific encephalopathic features, seizures, stroke
microvascular thrombosis

24
Q

What’s the prognosis for HUS?

A

<5% mortality but 50% of children need dialysis during the acute phase
70% fully recover, 30% have chronic renal insufficiency

25
Q

single umbilical artery

A

if no other abnormality then likely not a problem
associated abnormalities with renal abnormalities:
- ear abnormalities, GU, pulmonary hypoplasia, imperforate anus, scoliosis

26
Q

Definition of hypertension urgency

A

> 99th percentile BP
headache or vomiting but no signs of end organ damage
tx: IV or PO

27
Q

hypertension emergency

A

> 99th percentile BP with encephalopathy, seizures or renal dysfunction
fragile vessels and the blood pounding them, lots of pressure
wrecks your organs like a typhoon.
tx: must be IV

28
Q

How fast should you decrease the BP?

A

don’t go too fast because you don’t want to reduce the perfusion to the organ
goal of 25% decrease over the 1st 8 hours
normalization over the next 48 hours
regardless of whether they are still symptomatic

29
Q

Aside from nifedipine, 3 other meds for acute BP

A

nitro
labetalol
hydralazine

30
Q

Most common cause of nephrotic syndrome in children

A

minimal change disease

31
Q

What is the treatment for minimal change disease

A

steroids

32
Q

In a child with nephrotic syndrome, when to biopsy

A

if steroids fail, or if older age

33
Q

BP in nephrotic syndrome

A

should be nomal (although can be elevated in 25%, but shouldn’t be in typical minimal change disease (baby nelson)

34
Q

Treatment of rhabdo

A

either dialysis or mannitol (to help with osmotic diuresis)
because doesn’t act on the kidneys
(vs lasix actually acts on stuff)
benefit of mannitol is not established

35
Q

Why do you get polyuria with ATN?

A

3 phases

  1. acute decrease in GFR with sudden increase in BUN/Cr
  2. maintenance - severe sustained reduction in GFR
  3. recovery - tubular function restored - increase in u/o volume at that point
36
Q

Abdominal compartment syndrome

A

abdominal compartment

  1. low u/o
  2. hypotension
  3. resp distress because of increased abdominal pressure
37
Q

How to measure abdominal compartment pressure?

A

bladder probe - manometer - on the end of a foley

38
Q

increased anion gap

A

mudpiles
i is isoniazzid and iron
non anion gap: is RTA and diarrhea

39
Q

Bartters syndrome

A

loop of henle problem
autosomal recessive
metabolic alkalosis - present with persistent vomiting, polyuria and polydipsia

40
Q

kid not peeing and hyponatremic

urine SP gravity 1.020 (concentrated)

A

fluid restrict 1L/m2/24 hours

41
Q

4 year old with hematuria on two urine dips, has a grandfather with renal stones

A

urine calcium/creatinine ratio

>0.2 think of stones

42
Q

random microscopic hematuria

A

check BP, repeat the urine (2 more times), check for protein

43
Q

proteinuria - false positive

A

antiseptic agent
if urine is alkaline
if the dipstick stays there too long

44
Q

most common cause of persistent proteinuria

A

orthostatic proteinuria
test for this diagnosis: first morning urine x 2/3
urine protein/Cr ratio <0.2 then confirms diagnosis

45
Q

when to refer to paediatric surgeon for undescended testicle

A

should refer by 6 months (most descent by 4 months?, somewhere else says 9 months)
2 complications:
- infertility
- undetected cancer/cancer

46
Q

5 month old with UTI, 2 indications for prophylaxis

A
  1. high grade reflux
  2. obstruction - ie PUV

reasons for urology
1. hypertension 2. impaired renal function3. renal abnormalities

47
Q

reducible hernia, when to refer?

A

does not resolve spontaneously, early repair reduces the chance of incarceration, should do within 6-12 months of life
70% of incarcerated occur in the first year of life
can get testicular atrophy from inguinal hernia
for the routine hernia, operation should be done shortly after diagnosis

Nephrology (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions