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Peds II > Exam 2 renal/HTN > Flashcards

Exam 2 renal/HTN Flashcards

1
Q

decreased C3 in the setting of glomerulonephritis ddx

A

postinfectious GN, MPGN, lupus nephritis

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2
Q

normal C3 in the setting of glomerulonephritis ddx

A

IgA nephropathy, HSP nephritis, ANCA, Alport syndrome

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3
Q

most common cause of glomerulonephritis

A

IgA nephropathy

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4
Q

classic features of hemolytic uremic syndrome

A

microangiopathic hemolytic anemia, thrombocytopenia, renal dysfunction

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5
Q

younger patients have ____normal creatinine levels

A

lower

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6
Q

stage 3 AKI

A

SCr 3x baseline or to 4.0 mg/dl or eGFR<35, or initiation of dialysis

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7
Q

how to classify chronic kidney disease for age <2

A

(urinary protein or albumin above normal value for age)

mild: 1 standard deviation below mean GFR for age
moderate: between 1 and 2
severe: more than 2

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8
Q

consequences of chronic kidney disease

A

neurocognitive problems, HTN, dyslipidemia, anemia, electrolyte abnormalities, abnormal urine output, growth failure, delayed puberty

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9
Q

reticulocyte count in CKD

A

low

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10
Q

treatment of growth failure in CKD

A

good nutrition, normalize bicarb, treat MBD, growth hormone

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11
Q

etiology of growth failure in CKD

A

metabolic acidosis, malnutrition, mineral/bone disorder, growth hormone resistant state

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12
Q

2 types of dialysis

A

hemodialysis and peritoneal dialysis

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13
Q

classic presentation of glomerulonephritis

A

hematuria, edema, hypertension, proteinuria

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14
Q

3 main categories of acute glomerulonephritis

A

post-infectious, IgA nephropathy, PAN

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15
Q

etiologies of post-infectious GN

A

usually strep

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16
Q

post-infectious GN treatment

A

manage fluid levels, treat HTN, rarely dialysis

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17
Q

how long does microscopic hematuria last after post-infectious GN

A

up to 1 year

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18
Q

when does C3 normalize after post-infectious GN

A

6-8 weeks

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19
Q

differences between IgA nephropathy and post-infectious GN

A

IgA occurs more rapidly after URI, with recurrent hematuria and a normal C3

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20
Q

IgA nephropathy presentation

A

abdominal pain, N/V/bloody diarrhea, foot/ankle edema, palpable purpura on lower extremities, joint inflammation/pain

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21
Q

hydronephrosis definition

A

dilation of kidney pelvis and calyces

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22
Q

3 major causes of postnatal hydronephrosis

A

transient, vesicoureteral reflux, obstruction

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23
Q

tests for reflux or obstruction

A

voiding cysto-urethrogram, renal scan

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24
Q

issues associated with horseshoe kidney

A

UTIs, obstruction, and kidney stones

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25
Q

nephrotic syndrome is defined by

A

proteinuria, hypoalbuminemia, edema, hyperlipidemia

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26
Q

most common cause of nephrotic syndrome in children

A

minimal change disease

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27
Q

primary treatment for minimal change nephrotic syndrome

A

steroids (prednisone)

28
Q

remission of minimal change disease defined as

A

absence of proteinuria

29
Q

corticosteroids side effects

A

decreased growth, osteoporosis, increased appetite, HTN, glaucoma, increased infection, central body fat, hirsutism, peptic ulcer

30
Q

most common form of polycystic kidney disease

A

autosomal dominant

31
Q

most common mutation in polycystic kidney disease

A

PKD1 gene

32
Q

problems associated with ADPKD

A

pain, UTI, infected/bleeding cysts, stones, HTN, reduced kidney function

33
Q

extrarenal manifestations of ADPKD

A

cardiac abnormalities, intestinal diverticula, hepatic cysts, pancreatic cysts, aortic aneurysms, intracranial aneurysms, abdominal hernias, thyroid cysts

34
Q

treatment of ADPKD

A

manage proteinuria, HTN

35
Q

medication for ADPKD (for adults only)

A

tolvaptan

36
Q

problems associated with ARPKD (rare)

A

underdeveloped lungs, HTN, eating difficulties, UTIs, liver fibrosis

37
Q

renal artery thrombosis common cause

A

newborns with umbilical artery catheters

38
Q

renal vein thrombosis presentation

A

hematuria, thrombocytopenia, proteinuria

39
Q

causes of renal vein thrombosis

A

nephrotic syndrome, kidney transplant, newborns

40
Q

treatment for renal vein thrombosis

A

heparin

41
Q

hemolytic uremic syndrome is defined by

A

hemolytic anemia, thrombocytopenia, AKI

42
Q

HUS is most often caused by

A

E. coli

43
Q

HUS treatment

A

supportive care with dialysis if AKI is severe

44
Q

nonpharmacologic treatment for peds HTN

A

weight loss 0.5-1 lb per week, healthy diet, sodium restriction, 1 hour of exercise most days of week. Follow up in 3 months

45
Q

Pharmacologic treatment for peds HTN - when to initiate

A

symptomatic, stage 2, persistent stage 1, evidence of end-organ damage, DM, CKD

46
Q

pharmacologic treatment for peds HTN - agents

A

thiazides, ACEI, ARB, CCB

47
Q

when to initiate sports restrictions for HTN

A

stage 2

48
Q

BP guidelines for peds>13

A

same as adult

49
Q

BP guidelines for peds between 1 and 13

A

normal <90%ile
elevated between 90-95th %ile OR between 120/80 and 95%ile
stage 1: between 95th %ile and 95%ile +12 or adult guideline
stage 2: greater than 95th %ile+12 or adult guideline

50
Q

standard peds BP screening

A

yearly in patients 3 years and older

51
Q

when should BP be monitored every visit

A

obese, renal disease, DM, aortic obstruction/coarctation, on BP meds

52
Q

treatment goal for peds BP

A

reduce systolic and diastolic to less than 90th %ile or 130/80 (in 13 and older)

53
Q

estimated GFR formula

A

0.413*height/serum creatinine

54
Q

when can infant’s creatinine be disregarded

A

during first 14 days of life

55
Q

definition of CKD

A

ssx for 3 or more months or structural kidney problem

56
Q

stage 1 AKI

A

SCr 1.5-1.9 times baseline OR >0.3 increase OR urine output <0.5mL/kg/hour for 6-12 hours

57
Q

stage 2 AKI

A

Scr 2.0-2.9 times baseline OR <0.5mL/kg/hr over 12 hours

58
Q

stage 3 AKI

A

3x baseline OR urinte output <0.3 mL/kg/hour for 24 hours OR anuria for 12 hours

59
Q

causes of prerenal AKI

A

nephrotic syndrome, NSAIDs, ACEI

60
Q

causes of renal AKI

A

GN, HUS, nephrotoxins

61
Q

when at risk for AKI (due to meds)

A

3 or more nephrotoxins

62
Q

proteinuria in glomerulonephritis

A

> =1+ proteinuria, 0.2 on spot urine protein

63
Q

what happens if GN turns into RGPN

A

may treat with glucocorticoids after biopsy

64
Q

treatment for MCD

A

high-dose steroids for 12 weeks

65
Q

medication for ADPKD not approved for peds

A

tolvaptan

Peds II (2 decks)

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