Kids And Kidneys

Question 1

Normal BP in children?

Answer 1

.

Question 2

Causes of childhood hypertension?

Answer 2

White coat HT
Organic: renal, cardiac, endocrine
Lifestyle, familial (more and more these days)

Question 3

End organ damage of HTN

Answer 3

Eyes
LVH
Kidneys(proteinuria)

Question 4

Malignant HT? Symptoms? How to treat?

Answer 4

Headaches
Blurry vision
Nausea-vomiting
Symptoms of raised ICP
Slow-reduction of BP

Question 5

Podocyte dysfunction get?

Answer 5

Proteinuria

Question 6

Endothelial or BM dysfunction you get?

Answer 6

Haematuria

Question 7

Haematuria: 3 things to consider for DDx

Answer 7

Pain
BP
Any proteinuria?

Question 8

Always do what after urine dipstick?

Answer 8

Do a formal microscopy

Question 9

Medical renal disease causes?

Answer 9

Hypercalciuria (crystals irritating)
Thin BM disease
Alport syndrome: X-linked
GN -IgA, HSP
Coagulopathy

Question 10

Urological causes of haematuria?

Answer 10

Calculus
Tumour
Stricture
Trauma

Question 11

How to assess proteinuria

Answer 11

24 hr collection

Spot collection

Question 12

Glom HT causes?

Answer 12

Hyper filtration
Compensate for podocyte loss
Increased podocyte loss

Question 13

Podocyte regenerates?

Answer 13

Nope

Question 14

If find protein in urine, then do what?

Answer 14

Protein creatinine ratio

Question 15

Minimal change disease cause?

Answer 15

Triggered by infection

Atopic

Question 16

What age Minimal change disease?

Answer 16

Age 2-10

Question 17

How to treat Minimal change disease?

Answer 17

Steroids: 2 weeks of high dose

Question 18

Types of Glomerulonephritis?

Answer 18

FSGS, MPGN, SLE

Question 19

Danger of Minimal change disease?

Answer 19

Relapses

Question 20

Nephrotic syndrome def’n?

Answer 20

Acute inflammation, impaired filtration

Question 21

Nephrotic syndrome you see what?

Answer 21

Haematuria - macroscopic
Proteinuria
Renal impairement, raised creatinine
Oliguria

Question 22

What to use to visualize cells in urine in nephritic syndrome?

Answer 22

Phase contrast microscopy

Question 23

Paediatric nephrotic syndrome, common cause?

Answer 23

Post-strep GN 2-4 weeks after

But any GN like SLE, IgA can cause it

Question 24

Most important levels for post-strep GN?

Answer 24

Low complement levels: C3, C4

Question 25

Rx for post-strep GN?

Answer 25

Furesemide

Question 26

Causes of HUS?

Answer 26

Ecoli - shiva toxin Uncooked meat Outbreaks

Question 27

HUS classic presentation?

Answer 27

``` Thrombotic microangiopathy Physical destruction from micro thrombi Not immune mediated Anaemia Thrombocytopaenia ```

Question 28

What do you need to diagnose HUS?

Answer 28

Blood film | RBC fragments

Question 29

HSP presentation?

Answer 29

``` Not really febrile Small vessels vasculitis GI Skin Joints ```

Question 30

Long term risk of HSP?

Answer 30

Renal: nephritis - looks like IgA

Question 31

Management of HSP?

Answer 31

acute - Steroids | Doesn't prevent kidney involvement

Question 32

HSP don't forget?

Answer 32

Follow up, can take up to 6/12 for renal involvement in HSP to show up.

Question 33

Angiotensin II will constrict what in lower levels?

Answer 33

likes to constrict Efferent arterioles

Question 34

What common drug kids reduces prostaglandins production?

Answer 34

Ibuprofen

Question 35

AKI - renal retention - water:

Answer 35

Oedema

Question 36

AKI - renal retention -Na:

Answer 36

HTN

Question 37

AKI - renal retention -K+:

Answer 37

Arrythmias

Question 38

AKI - renal retention -acid:

Answer 38

Hyperventilation

Question 39

AKI - renal retention -urea:

Answer 39

Nausea or vomiting

Question 40

AKI - renal retention -phosphate:

Answer 40

Tetany, decrease Calcium

Question 41

CKD in kids complications?

Answer 41

Anaemia Bone disease Impaired growth Polyuria/polydipsia

Question 42

Kidney transplantation worse outcomes in what age groups?

Answer 42

Adolescents: difficulty with adherence