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Pediatrics (Past Year) > Kidney > Flashcards

Kidney Flashcards

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1
Q

Definition and causative organism of acute Post Streptococcal GN

A

Inflammation of renal tissue characterise by

  • hematuria
  • edema
  • Hypertension
  • renal insufficiency

due to B-hemolytic streptococci group A

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2
Q

Clinical picture of Acute Post Streptococci GN

A
  • above 3 years
  • has history of infection 1-2 weeks before
  • fever
  • hypertension
  • abdominal pain
  • edema
  • oliguria
  • resolve in 4-6 weeks
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3
Q

Complication of Acute Post Streptococci GN

A

*ECAH

Electrolyte imbalance
Congestive HF
Acute renal failure
Hypertensive encephalopathy

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4
Q

Investigation of Acute Post Streptococci GN

A
  • urine: microscopic hematuria, RBC cast, Proteinuria
  • mild anemia
  • decrease serum C3
  • RFT nomal
  • Throat culture +ve
  • Increase antistreptolysin O titre
  • increase DNAse
  • increase streptokinase
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5
Q

Treatment of Acute Post Streptococci GN

A
  1. Prevention: Systemic Ab
  2. Curative:
    - 10 days course of penicillin
    - bed rest
    - Na bicarbonate
    - Antihypertensive: CCB, VD, Diuretic
    - ttt of convulsion: Diazepam
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6
Q

Definition Minimal change GN (nephrotic syndrome)

A

clinical laboratory condition characterised by:

  • heavy proteinuria (more 1g/m²/day)
  • hypercholesterolemia (more 250mg/dL)
  • hypoalbuminemia (less 2.5g/dL)
  • generalized edema
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7
Q

Clinical picture of Minimal change GN (nephrotic syndrome)

A
  1. Generalized edema (from eye & LL)
2. Relapse/ recurrent
may cause:
- ascites
- pleural effusion
- pericardial effusion
  1. no other manifestation
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8
Q

Investigate of Minimal change GN (nephrotic syndrome)

A
  • Proteinuria (moderate)
  • No hematuria
  • No RBC cast
  • Plasma protein less 4.5g/dl
  • serum cholesterol more 220mg/dl
  • normal C3 level, blood urea, serum cretinine
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9
Q

Complication of Minimal change GN (nephrotic syndrome)

A
  • arterial thrombosis
  • venous thrombosis
  • bacteria infection: cellulitis, pneumonia
  • renal impairment
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10
Q

Treatment of Minimal change GN (nephrotic syndrome)

A
  1. Observation
    - Temperature
    - Weight gain
    - BP
  2. Diet
    - decrease Na, fat
    - increase protein, calories
  3. Drugs:
    a) corticosteroid therapy:
    - Prednisone 60mg/m²/day (4-6 weeks consecutive)
  • alternative therapy- lower dose to 40mg/m²/day and discontinue after 2-3 month.
    b) Ab: Penicillin 400k IU /day
    c) Diuretic: Furasamide 1-2 mg/kg/dose orally
    d) Low dose Aspirin
    e) Vaccination
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11
Q

Definition and Clinical picture of Chronic renal failure

A

Definition:

gradual loss of renal function with irreversible reduction of GFR

CP:

  • non specific: headache, fatigue, anorexia, vomit
  • Pallor
  • hypertension
  • oliguria
  • edema
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12
Q

Investigation of Renal Failure

A
  • increase serum creatinine (N: 0.5-1.5mg%)
  • increase blood urea (20-40mg%)
  • increase serum K (3-5 mEq/L)
  • increase serum phosphate (3.5-5.5mg%)
  • decrease serum Ca (9-11mg%)
  • decrease serum Na (130-145 mEq/L)
  • metabolic acidosis
  • renal US
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13
Q

Treatment of Renal Failure

A
  1. treat of the cause
    - saline
    - ttt of infection
    - stop nephrotoxic drug
  2. nutrition
    - increase carbohydrate
    - decrease K, phosphate
  3. Ttt hyperkalemia
    - Na HCo3
    - Ca gluconate
  4. ttt hyperphospate: Ca Carbonate (oral)
  5. ttt hypocalcium: Ca Gluconate (IV)
  6. ttt hyponatremia: fluid restriction
  7. ttt Acidosis: Na HCo3
  8. Antihypertensive
  9. Dialysis
10. Remove cause of obstruction (acute)
Renal transplant (chronic)
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14
Q

Definition acute renal failure

A

clinical syndrome
characterized by sudden drop of renal function
with fluid and electrolyte disturbace

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15
Q

Etiology of acute Renal Failure

A
  1. Prerenal
    - Dehydration
    - Hemorrhage
    - Burn
  2. Renal
    - PSGN
    - pyelonephritis
    - acute hemolysis
    - severe hemolysis
    - renal artery thrombosis
    - Drug: NSAID
    - Injury
  3. Postrenal
    - Stone
    - Tumour
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16
Q

Clinical picture of Acute Renal Failure

A
  1. Prerenal
    - Dehydration
    - Oliguria
  2. Renal
    - Hypertension
    - hypertensive encephalopaty
    - congestive HF
    - edema
    - oliguria
  3. Postrenal
    - palpable renal mass
17
Q

Clinical picture of Urinary Tract Infection

A
  • Bacteriuria
  1. Newborn
    - septicemia
    - poor feeding
    - temperature instability
    - jaundice
  2. child
    a) Upper UTI
    * Pyelonephritis
    - fever
    - loin pain
    - if chronic: Renak failure, anemia, HTN

b) Lower UTI
* Cystitis, urethritis
- Dysuria
- Frequency
- Drippling
- Urgency
- Hematuria

18
Q

Investigation of Urinary Tract Infection

A
  • urine analysis: Pus cells
  • urine culture: 100 000 colony/ml
  • Blood culture: +ve
  • CBC: increase ESR, +ve CRP
  • RFT: serum cretinine
  • Radiology: US, Renal DMSA scan
19
Q

Treatment of Urinary Tract Infection

A
  1. Adequate hydration
  2. Ab
    a) Neonate
    - Ampicillin 100mg/kg/day
    - Gentamycin 5mg/kg/day
    - Cephalosporin 100mg/kg/day

b) Child
- Trimethoprim 8mg/kg/day
- Amoxicilin 50mg/kg/day

  1. Follow up
20
Q

Causes of hematuria

A
  1. W no blood on dipstick
    - ingest food
    - medication
    - chemical
  2. W blood on dipstick, no microscopic
    - DIC
    - acute intravascular hemolysis
    - crush injury
    - burn
  3. W blood on dipstick, microscopic, no cast
    - renal parenchymal disease
  4. W blood on dipstick, microscopic, cast
    - PSGN
    - Acute tubular necrosis
  • other:
  • drug: anticoagulant
  • stone
  • GN

Pediatrics (Past Year) (10 decks)

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