Gastro-Nephro Flashcards
What are the signs of shock in acute gastroenteritis?
Tachycardia, weak pulse volume, prolonged CRT >2s, cold peripheries, depressed mental state, with or without hypotension.
What are common viral causes of acute gastroenteritis?
Rotavirus (most common), norovirus.
What are common bacterial causes of acute gastroenteritis?
Campylobacter jejuni, E. coli, Salmonella, Vibrio cholera, Bacillus cereus.
What are common parasitic causes of acute gastroenteritis?
Entamoeba histolytica, Giardia lambdia, Cryptosporidium spp.
What laboratory findings suggest metabolic acidosis in gastroenteritis?
ABG: low pH, low bicarbonate.
How is oral rehydration solution (ORS) administered in gastroenteritis?
20-40 ml/kg over 4 hours, frequent small sips, continue giving extra fluid until diarrhea stops.
What are the complications of acute gastroenteritis?
Secondary lactose intolerance, hemolytic uremic syndrome (HUS), hypovolemic shock, electrolyte imbalance, metabolic acidosis.
Pathophysiology:
Diarrhea & vomiting → excessive fluid loss
Loss of Na⁺, K⁺, Cl⁻, HCO₃⁻ → hypovolemia, hypotension, and shock
Loss of K⁺ → hypokalemia → muscle weakness, arrhythmias
Loss of HCO₃⁻ → metabolic acidosis (from bicarbonate loss in diarrhea)
⏳ Complications:
Hypovolemic shock (low blood pressure, organ failure)
Electrolyte disturbances (arrhythmias, seizures)
Metabolic acidosis (rapid breathing, confusion)
What are the three categories of dehydration severity?
Mild (5%), moderate (5-10%), severe (>10%).
What is the first-line treatment for severe dehydration?
IV normal saline (NS) 10-20 ml/kg over 15-30 minutes.
What are primary causes of nephrotic syndrome?
Idiopathic nephrotic syndrome (most common), membranous nephropathy, membranoproliferative glomerulonephritis, IgA nephropathy.
What are secondary causes of nephrotic syndrome?
SLE, vasculitis (Henoch-Schönlein purpura), poststreptococcal glomerulonephritis, infective endocarditis.
What are the clinical features of nephrotic syndrome?
Edema (periorbital, lower extremities, sacral, scrotal), proteinuria (>50 mg/kg/day), hypoalbuminemia (<3 g/dL), hyperlipidemia.
What is the first-line treatment for idiopathic nephrotic syndrome?
Prednisolone 60 mg/m²/day for 4 weeks, then alternate-day 40 mg/m²/day for 4 weeks, then taper over 4 weeks.
What supportive management is needed for nephrotic syndrome?
Low-salt diet, strict I/O monitoring, ACE inhibitors (Captopril) for hypertension, prophylactic penicillin.
What defines steroid-resistant nephrotic syndrome?
Failure to respond to initial 4-week prednisolone therapy, or two consecutive relapses during tapering or within 14 days after stopping steroids.
What are complications of nephrotic syndrome?
Infection (due to immunosuppression), thromboembolism, growth suppression due to steroids.
What is the most common cause of postinfectious glomerulonephritis?
Group A beta-hemolytic Streptococcus (GAS).
What is the classic triad of poststreptococcal glomerulonephritis (PSGN)?
Hematuria (tea-colored urine), hypertension, edema.
How is PSGN diagnosed?
Evidence of recent GAS infection (ASO titer, positive throat culture), hematuria, proteinuria, reduced C3 levels.
What is the first-line treatment for PSGN?
Supportive care, loop diuretics (furosemide) for hypertension, low-salt diet, antibiotics if infection is still present.
What is the most common cause of urinary tract infections (UTIs)?
Escherichia coli.
What factors predispose to UTIs?
Female sex, vesicoureteral reflux (VUR), urinary stasis, constipation, catheterization.
What is the recommended initial investigation for UTI in children?
Urine dipstick (leukocyte esterase, nitrites), urine microscopy & culture.
What imaging is indicated for recurrent UTIs or structural abnormalities?
Renal ultrasound (RUS), micturating cystourethrogram (MCUG), nuclear renal scan.
