Exam 2 renal/HTN

Question 1

decreased C3 in the setting of glomerulonephritis ddx

Answer 1

postinfectious GN, MPGN, lupus nephritis

Question 2

normal C3 in the setting of glomerulonephritis ddx

Answer 2

IgA nephropathy, HSP nephritis, ANCA, Alport syndrome

Question 3

most common cause of glomerulonephritis

Answer 3

IgA nephropathy

Question 4

classic features of hemolytic uremic syndrome

Answer 4

microangiopathic hemolytic anemia, thrombocytopenia, renal dysfunction

Question 5

younger patients have ____normal creatinine levels

Answer 5

lower

Question 6

stage 3 AKI

Answer 6

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

Question 7

how to classify chronic kidney disease for age <2

Answer 7

(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

Question 8

consequences of chronic kidney disease

Answer 8

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

Question 9

reticulocyte count in CKD

Answer 9

low

Question 10

treatment of growth failure in CKD

Answer 10

good nutrition, normalize bicarb, treat MBD, growth hormone

Question 11

etiology of growth failure in CKD

Answer 11

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

Question 12

2 types of dialysis

Answer 12

hemodialysis and peritoneal dialysis

Question 13

classic presentation of glomerulonephritis

Answer 13

hematuria, edema, hypertension, proteinuria

Question 14

3 main categories of acute glomerulonephritis

Answer 14

post-infectious, IgA nephropathy, PAN

Question 15

etiologies of post-infectious GN

Answer 15

usually strep

Question 16

post-infectious GN treatment

Answer 16

manage fluid levels, treat HTN, rarely dialysis

Question 17

how long does microscopic hematuria last after post-infectious GN

Answer 17

up to 1 year

Question 18

when does C3 normalize after post-infectious GN

Answer 18

6-8 weeks

Question 19

differences between IgA nephropathy and post-infectious GN

Answer 19

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

Question 20

IgA nephropathy presentation

Answer 20

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

Question 21

hydronephrosis definition

Answer 21

dilation of kidney pelvis and calyces

Question 22

3 major causes of postnatal hydronephrosis

Answer 22

transient, vesicoureteral reflux, obstruction

Question 23

tests for reflux or obstruction

Answer 23

voiding cysto-urethrogram, renal scan

Question 24

issues associated with horseshoe kidney

Answer 24

UTIs, obstruction, and kidney stones

Question 25

nephrotic syndrome is defined by

Answer 25

proteinuria, hypoalbuminemia, edema, hyperlipidemia

Question 26

most common cause of nephrotic syndrome in children

Answer 26

minimal change disease

Question 27

primary treatment for minimal change nephrotic syndrome

Answer 27

steroids (prednisone)

Question 28

remission of minimal change disease defined as

Answer 28

absence of proteinuria

Question 29

corticosteroids side effects

Answer 29

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

Question 30

most common form of polycystic kidney disease

Answer 30

autosomal dominant

Question 31

most common mutation in polycystic kidney disease

Answer 31

PKD1 gene

Question 32

problems associated with ADPKD

Answer 32

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

Question 33

extrarenal manifestations of ADPKD

Answer 33

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

Question 34

treatment of ADPKD

Answer 34

manage proteinuria, HTN

Question 35

medication for ADPKD (for adults only)

Answer 35

tolvaptan

Question 36

problems associated with ARPKD (rare)

Answer 36

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

Question 37

renal artery thrombosis common cause

Answer 37

newborns with umbilical artery catheters

Question 38

renal vein thrombosis presentation

Answer 38

hematuria, thrombocytopenia, proteinuria

Question 39

causes of renal vein thrombosis

Answer 39

nephrotic syndrome, kidney transplant, newborns

Question 40

treatment for renal vein thrombosis

Answer 40

heparin

Question 41

hemolytic uremic syndrome is defined by

Answer 41

hemolytic anemia, thrombocytopenia, AKI

Question 42

HUS is most often caused by

Answer 42

E. coli

Question 43

HUS treatment

Answer 43

supportive care with dialysis if AKI is severe

Question 44

nonpharmacologic treatment for peds HTN

Answer 44

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

Question 45

Pharmacologic treatment for peds HTN - when to initiate

Answer 45

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

Question 46

pharmacologic treatment for peds HTN - agents

Answer 46

thiazides, ACEI, ARB, CCB

Question 47

when to initiate sports restrictions for HTN

Answer 47

stage 2

Question 48

BP guidelines for peds>13

Answer 48

same as adult

Question 49

BP guidelines for peds between 1 and 13

Answer 49

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

Question 50

standard peds BP screening

Answer 50

yearly in patients 3 years and older

Question 51

when should BP be monitored every visit

Answer 51

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

Question 52

treatment goal for peds BP

Answer 52

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

Question 53

estimated GFR formula

Answer 53

0.413*height/serum creatinine

Question 54

when can infant's creatinine be disregarded

Answer 54

during first 14 days of life

Question 55

definition of CKD

Answer 55

ssx for 3 or more months or structural kidney problem

Question 56

stage 1 AKI

Answer 56

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

Question 57

stage 2 AKI

Answer 57

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

Question 58

stage 3 AKI

Answer 58

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

Question 59

causes of prerenal AKI

Answer 59

nephrotic syndrome, NSAIDs, ACEI

Question 60

causes of renal AKI

Answer 60

GN, HUS, nephrotoxins

Question 61

when at risk for AKI (due to meds)

Answer 61

3 or more nephrotoxins

Question 62

proteinuria in glomerulonephritis

Answer 62

>=1+ proteinuria, 0.2 on spot urine protein

Question 63

what happens if GN turns into RGPN

Answer 63

may treat with glucocorticoids after biopsy

Question 64

treatment for MCD

Answer 64

high-dose steroids for 12 weeks

Question 65

medication for ADPKD not approved for peds

Answer 65

tolvaptan