GU Flashcards
What is Fanconi syndrome?
A syndrome of inadequate reabsorption in the proximal renal tubules of the kidney. The syndrome can be caused by various underlying congenital or acquired diseases, by toxicity (for example, from toxic heavy metals), or by adverse drug reactions (e.g. gentamycin, outdated tetracycline). It results in various small molecules of metabolism being passed into the urine instead of being reabsorbed from the tubular fluid (for example, glucose, amino acids, uric acid, phosphate, and bicarbonate). Symptoms are nonspecific and include anorexia, polydipsia and polyuria, vomiting, and unexplained fevers. The more specific laboratory abnormalities are glucosuria but normal blood sugar, abnormally high urine pH in the face of mild or moderate serum hyperchloremic metabolic acidosis, and mild albuminuria in the presence of normal serum protein and albumin.
What is lobar nephronia?
It refers to an intermediate stage between acute pyelonephritis and renal abscess, and is a focal region of interstitial nephritis. It appears as a wedge of poorly perfused renal parenchyma on CT. Patients have prolonged fever curves. Treatment is with prolonged antibiotics.
What are symptoms of idiopathic hypercalciuria?
Idiopathic hypercalciuria causes recurrent gross hematuria, persistent microscopic hematuria, and complaints of dysuria or abdominal pain without initial stone formation. Over time, however, stones may form in 15% of cases.
How should fluids be managed in acute glomerulonephritis?
Fluids should be restricted to prevent massive edema which can be life-threatening (e.g. leading to pulmonary edema)
How is blood pressure affected in glomerulonephritis vs nephrotic syndrome?
HTN is common in glomerulonephritis, but is rare in nephrotic syndrome
What is Bartter syndrome?
A rare inherited defect in the thick ascending limb of the loop of Henle. It is characterized by hypokalemia, alkalosis, hypercalciuria, hyperaldosteronism, hyperreninemia, and normal to low blood pressure. Clinical presentations occurring frequently between 6 and 12 months of age include failure to thrive with constipation, weakness, vomiting, polyuria, and polydipsia. Treatment is aimed at preventing dehydration, providing nutritional support, and returning the potassium level to normal. Think loop diuretic actions
What is Gitelman syndrome?
An autosomal recessive kidney disorder characterized by hypokalemia, hypomagnesemia, hypocalciuria, and alkalosis. The disorder is caused by genetic mutations resulting in improper function of the thiazide-sensitive sodium-chloride symporter located in the distal convoluted tubule of the kidney. Many patients are asymptomatic and those that are symptomatic present with symptoms similar to thiazide diuretics.
What are the common causes of glomerulonephritis in children?
Post-Streptococcal GN, membranoproliferative GN, IgA nephropathy, and Henoch-Schonlein pupura (requires rash for dx). Severe presentations may represent rarer causes such as RPGN, Wegener’s, and Goodpasture’s (anti-GBM). Can also have SLE GN
What is considered an abnormal urine protein output in a child < 10 yrs?
> 100 mg/24 hours
How is minimal change disease treated?
Corticosteroids (most nephrotic syndromes are treated with steroids)
How are complement levels affected in Streptococcal GN?
Low C3 and normal C4
What fluid considerations should you have in nephritic syndrome?
Do not give NS (already fluid overloaded in the intravascular space)
What is Prehn sign?
Elicited by gently lifting the scrotum toward the symphysis. Relief of the pain points to epididymitis; its worsening, to torsion.
How does ultrasound help differentiate between testicular torsion and epididymitis?
Doppler ultrasound of blood flow will demonstrate absence of flow in torsion and increased flow in epididymitis.
What is Denys-Drash syndrome?
Characterized by gonadal dysgenesis, nephropathy and Wilm’s tumor
